An Investigation into the Pattern of Antibiotic Resistance of Bacteria Causing Ventilator – Associated Pneumonia in ICU

Aims: The present study sought to determine the pattern of antibiotic resistance of pathogens in Ventilator–Associated Pneumonia (VAP) and to investigate risk factors of multi-drug resistant (MDR) in ICUs of tertiary referral hospitals.

Study Design: Cross sectional study.

Place and Duration of Study: In this cross sectional study, the files of 196 patients with VAP hospitalized in ICU of tertiary referral hospitals in 2014 were examined.

Methodology: In order to determine common pathogens and their pattern of antibiotic resistance, the patients’ results of culturing Bronchoalveolar fluid were examined. The agent pathogens were divided in two groups of with and without MDR and different demographic and risk factors for resistance were compared into the two groups.

Results: Among from 196 patients examined, 53 and 143 cases had early and late pneumonia, respectively. There was no significant difference between the early and late groups in regard to the frequency of MDR pathogens. There was no significant difference between the two groups with and without MDR in terms of age, gender, immune deficiency, duration of hospitalization and taking antibiotics. The most common early and late types were Acinetobacter baumannii (40.4%) and Klebsiella pneumoniae (31.8%), respectively and the minimal resistance of the bacteria was related to Colistin and amikacin antibiotics.

Conclusion: Considering the high and increasing prevalence of antibiotic resistance, measures such as providing samples for culture before prescribing antibiotics, starting empirical treatment based on the frequency of agent pathogens and the rate of their antibiotic resistance and avoiding prescription without indication of antibiotics seem necessary.