Microbiological study of ventilator associated pneumonia with antimicrobial susceptibility pattern of the isolated strains and its relation to nasal colonization in neonatal intensive care unit

The aim of this study is to analyze the microbiological profile of ventilator associated pneumonia (VAP) in relation to nasal swabs and prevalence of multi-drug resistant bacteria so as to implement effective treatment and prevention strategies in NICU (Neonatal Intensive Care Unit). One hundred neonates were ventilated for more than 48 h and met the inclusion criteria which were enrolled in the study. All cases were subjected to history taking, thorough clinical examination, Indications of mechanical ventilation, sputum and nasal swabs culture and sensitivity by conventional microbiological methods. As regard to positive sputum culture results, the rate of Klebsiella pneumoniae was 16.7% in cases with early onset VAP while it is 39.4% in cases with late onset VAP, Aceintobacter baumanni, Pseudomonas aeruginosa and combined P. aeruginosa and K. pneumoniae was 8.5% each in cases with late onset VAP. As regard, positive nasal swab culture results K. pneumoniae which was isolated from 16.7% of all cases, with early onset VAP while it was 23.4% in cases with late onset VAP, P. aeruginosa, combined P. aeruginosa and K. pneumonia was 8.5% each, and A. baumanni was 6.4% in cases with late onset VAP. Gram negative bacteria are the most common agents causing VAP in our study. There is a relationship between organisms in nasal swab and VAP. So, nasal screening for colonization may be a valuable tool for de-escalation of empiric therapy targeted to the organism.