Microbial etiologies of ventilator-associated pneumonia (VAP) in intensive care unit of Beni-Suef University's Hospital

Al Zahraa M Maebed; Yasser Gaber; Walid Bakeer; Tarek Dishisha

doi:10.1186/s43088-021-00130-x

Microbial etiologies of ventilator-associated pneumonia (VAP) in intensive care unit of Beni-Suef University's Hospital

Beni Suef Univ J Basic Appl Sci. 2021;10(1):41. doi: 10.1186/s43088-021-00130-x. Epub 2021 Jul 29.

Authors

Al Zahraa M Maebed¹, Yasser Gaber^{2

3}, Walid Bakeer², Tarek Dishisha²

Affiliations

¹ Department of Microbiology and Immunology, Faculty of Pharmacy, Nahda University, Beni Suef, Egypt.
² Department of Microbiology and Immunology, Faculty of Pharmacy, Beni-Suef University, Beni Suef, Egypt.
³ Department of Pharmaceutics and Pharmaceutical Technology, College of Pharmacy, Mutah University, Kerak, 61710 Jordan.

Abstract

Background: Ventilator-associated pneumonia (VAP) is a major health problem for people intubated in intensive care units (ICUs), leading to increased mortality rates, hospital stay, and treatment costs. In the present study, the core pathogens causing VAP in Beni-Suef University's Hospital, Egypt, was investigated over a study period of 2 years (2017-2019).

Results: Of a total of 213 patients subjected to mechanical ventilation, 60 have developed VAP during their stay in the ICU. The mortality rate reached 41.7% among VAP patients. Sixty bacteria were isolated from an endotracheal aspirate of hospitalized patients. The different isolates were cultured followed by running biochemical tests, sensitivity assays, and automated VITEK®2 System analysis. Unexpectedly, all the isolates were Gram-negative bacteria. Klebsiella pneumoniae were the main pathogen encountered (27/60 isolates) followed by Acientobacter baumannnii (7/60) and other microorganisms belonging to the genera Moraxella, Escherichia, and Pseudomonas (11/60). Antibiotic sensitivity testing was performed via the VITEK®2 System using up to 16 different antibiotics representing 8 different antibiotic classes and subclasses (aminoglycosides, carbapenems, fluoroquinolones, penicillin/β-lactamase inhibitor, extended-spectrum cephalosporins, aminopenicillins, aminopenicillins/β-lactamase inhibitor, folic acid synthesis inhibitor). Majority of the isolates (28/60) showed a remarkable extensive drug resistance (XDR) pattern, while 15 isolates were multi-drug resistant (MDR) and only 6 were pan-drug resistant (PDR) with regard to antibiotics under evaluation.

Conclusion: The association of VAP with multi-drug-resistant bacteria is alarming, and rapid management is crucial. Identification of core pathogens is essential for identifying the most appropriate technique for infection control.

Keywords: Acinetobacter baumanii; Antibiotic sensitivity testing; Intensive care unit; Klebsiella pneumoniae; Pathogens; VAP; Ventilator-associated pneumonia.