DOI: 10.36347/sasjm.2021.v07i01.002

Pages: 4-8

Introduction: Hospital-acquired pneumonia (HAP) is the second most common nosocomial infection and has higher morbidity and mortality and prolongs hospital stay for patients and excess costs for them [1, 2]. Most significant factor associated with HAP is mechanical ventilation (MV) [1]. High risk MDR pathogens, sepsis, septic shock, elderly patients, bilateral infiltrates in chest x ray and co-morbidities are associated with, increases incidence of HAP and mortality. Methods: This prospective study was conducted in medical intensive care unit (MICU) and respiratory intensive care unit (RICU) of tertiary care teaching medical college hospital over a period of 18 months. 1554 cases were included in the study based on ATS/IDSA 2016 HAP guidelines. Objective: We studied clinical, radiological, bacteriological profile and factors affecting the outcome of HAP patients. During the study, we also analyzed causative organisms. Results: Out of 1554 patients, 194(12.5%) patients developed HAP. Incidence of HAP among patients aged >60 years was 64%. 132 (68%) male patients and 62(32%) female patients developed HAP. 124 (22%) patients who were on mechanical ventilation had HAP. 52% HAP cases had chronic respiratory illness. 16% of HAP patients did not have any chronic systemic illness. Delirium was observed in most of the cases in higher age group. Bilateral infiltrates in chest x ray, sepsis, and septic shock are associated with high mortality. Most common organism isolated from sputum and endotracheal aspirate was Klebsiella pneumoniae. Conclusion: Incidence of HAP in this study was 12.5%. Patients with higher age group and male gender were predominantly affected. Mechanical ventilation more than 48 hours, comorbidities, old age, bilateral infiltrates in chest X ray, sepsis, septic shock and multidrug resistant (MDR) pathogens are associated with high mortality. Early diagnosis, effective preventive and therapeutic strategies, aiming to decrease morbidity, mortality and ......