Ventilator Associated Tracheobronchitis – Etiology and Outcome at an Intensive Care Unit of a Tertiary Care Center in North India

Background and Aim: Ventilator associated Tracheobronchitis (VAT) is a common nosocomial respiratory tract infection which develops in intubated critically ill patients. Their etiology changes with time, hospital and ICU setting and duration of hospital stay. This study was aimed at detecting the microbiological etiology of VAT, reporting the antimicrobial susceptibility pattern and impact on outcome. Materials and Methods: This observational study was conducted for 12 months in the Microbiology Department and intensive care unit of a tertiary care center. A total of 39 endotracheal secretions from suspected cases of VAT were subjected to routine bacterial culture and antimicrobial susceptibility testing. The outcome of the patients with VAT was measured in terms of duration of ventilation, hospital stay and mortality. Results: VAT was found to occur most commonly between 60-69 years of age and among the male population (79%). A total of 47 isolates were recovered from 39 samples. Monomicrobial growth was obtained from 34 (87.18%) of endotracheal samples, while 5 (12.82%) showed polymicrobial growth of at least two pathogens. The predominant organism isolated was Acinetobacter baumannii (27.65%), followed by Klebsiella pneumoniae (23.40%) and Pseudomonas aeruginosa (21.27%) and all were found to be multidrug resistant. The mean duration of ventilation, ICU Stay and hospital stay for VAT was 10.87 days, 12.20 and 16.27 respectively. Conclusion: It is imperative to timely diagnose and monitor cases of VAT as this would help in deriving an effective early therapeutic intervention and in implementing timely preventive strategies that could help reduce progression of VAT to Ventilator associated pneumonia (VAP).