Surveillance on Ventilator Associated Pneumonia in the Intensive

Surveillance on Hospital Associated Pneumonia in the Intensive Care Unit of Teaching Hospital, Kurunegala, Sri Lanka : 

Surveillance on Hospital Associated Pneumonia in the Intensive Care Unit of Teaching Hospital, Kurunegala, Sri Lanka D.M.A.B.M. Dissanayake Infection Control Nurse Teaching Hospital Kurunegala

Introduction : 

Introduction Pneumonia is the most common hospital associated infection is a leading cause of death due to hospital-acquired infections. Ventilator-associated pneumonia (VAP) is a form of hospital associated pneumonia that occurs in patients receiving mechanical ventilation for longer than 48 hours. The incidence of VAP in European country is 22.8% among patients receiving mechanical ventilation,.

Background : 

Background VAP is a critical problem among patients, who need mechanical ventilation. it is essential to find out the prevalence of VAP and commonest causative agents before launching educational and other programs to suppress the VAP

Literature Survey : 

Literature Survey Infection Control policies have a significant impact on HAI (Dr S.D Athukorala,Ceylon medical journal,1998) The study from Spain have examined the influence of initial empiric antibiotic therapy on the outcomes of patients with VAP. (Dr. Alvarez-Lerma, Meds Cap Today) Ventilator-associated pneumonia is the most frequent intensive care unit (ICU)-related infection in patients requiring mechanical ventilation. (Dr.Kimberly A Davis, Medical journal intensive care Medicine) Interventions beneficial to the prevention of ventilator-associated pneumonia would therefore have a significant impact on the care of these patients. (Dr.Harold R. Collard, MD, American college of medicine)

Objectives : 

Objectives To determine the incidence of Ventilator Associated Pneumonia in ICU ,Teaching Hospital Kurunegala

Methodology : : 

Methodology : Data was extracted from the formats available in the Infection Control Unit in the teaching hospital,kurunegala. All VAPs reported from January 2007 to December 2009 were included. All the definitions are according to the WHO guidelines.

Methodology cont. : 

Methodology cont. Data collection formats was duly filled by infection control nurses by screening the BHTs of ventilated patients under the assessment of in charge of the unit.

Methodology cont. : 

Methodology cont. Information gathered from VAP patients Name Age Sex Signs and symptoms of infections Details on ventilation (ventilated date, duration) Changes in chest X-ray Data on Microbiological investigations (causative agents and its antibiotic sensitivity pattern)

Hypothesis : 

Hypothesis Technical accuracy of laboratory workers and potency of antibiotic disks are al most all correct. Relevant Instruments are almost all are accurate in condition.

Data Analysis : 

Data Analysis done by Infection Control Nursing Officers, the Medical Officer & the Research Officer of the Department of Microbiology, under the supervision of Consultant Microbiologist

Results : 

Results Total number of the patient admitted to ICU during the period was 1878. 213 (13.20 %) patients developed VAP.

Results : 

Results * Many have been infected with more than one organisms

Results : 

Results Sensitivity pattern Majority of Pseudomonas were sensitive to Meropenam (82%), coliform - Amikacin (72%) Staphylococci - Fusicidic acid (81%).

Discussions : 

Discussions As pseudomonas is the most common isolate it is better to implement frequent infection control programs such as (1) hand washing and barrier nursing care (2) Proper patient care (3) Proper Cleaning and sterilization of relevant instrument Experiments on new antibiotics should also be launched as isolates have shown considerable resistance on prevailing ones.

Conclusion : 

Conclusion As published data on Surveillance on VAP in Sri Lanka is un common it is difficult to make a comparison on VAP rates in Sri Lanka. It is very important to find out the prevalence of VAP in special unit where the ventilation is frequentand reduce the rate if it is high

Slide 16: 

Thank You.