Original Research Article DOI: 10.18231/2456-012X.2017.0004 Indian Journal of Immunology and Respiratory Medicine, April-June 2017;2(2):36-41 36 Ventilator - Associated Pneumonia in Paediatric Intensive Care Unit at the Indira Gandhi Institute of Child Health S. Mahantesh 1 , J. Bhavana 2,* , GV Basavaraj 3 , Sist Elsamma Yohonnan 4 1 Associate Professor, 2 Assistant Professor, Dept. of Microbiology, 3 Associate Professor, Dept. of Paediatrics, 4 Infection Control Nurse, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka *Corresponding Author: Email: bhavana_druthi@yahoo.co.in Abstract Introduction: This is prospective study undertaken at the PICU of Indira Gandhi Institute of Child health to assess the risk factors causative organisms and outcome of paediatric Ventilator-Associated Pneumonia (VAP). Materials and Method: A total of 1079 patients who received Mechanical Ventilation (MV) were included in this prospective study during the period from January 2015 till September 2016. Cases were defined as VAP as per CDC guidelines. The causative organisms were isolated and identified along with their antibiogram. The clinical details and prognosis was noted of each patient until discharge or death. Results: VAP was detected in 74 patients among 1079 ventilated patients. VAP rate was 6.85 %, incidence density was 16.04. Gram negative bacteria was most frequent causative organism, Acinetobacter was the common causative 46 (62.1%); Pseudomonas aeroginousa 23(31%); Klebsiella 17 (22.97%); Enterobacter 10 (13.51%); E. coli 3(4 %) and Citrobacter in 2 (2.7%). Staphylococcus aureus and Candida were isolated in 1 sample each. Polymicrobial infection in 23 cases. Most of the isolates were multidrug resistant. The mortality rate was 28.38%. Conclusions: Identification of risk factors, causative organisms along with their antibiotic sensitivity pattern and outcome of patients with VAP in PICUs may help in reducing the incidence. This shall further help in formulating better Hospital infection control Policies and practices in the Paediatric intensive care unit. Keywords: Hospital acquired infection; Mechanical ventilation; Paediatric intensive care; Ventilator associated pneumonia Introduction Mechanical ventilation is the cornerstone for the management of critically ill children in intensive care setting. This modality has its own complications and hazards. One such complication as the chance of developing pneumonia termed the ventilator-associated pneumonia (VAP) [1]. Ventilator-associated pneumonia (VAP) is defined as nosocomial pneumonia developing 48 hrs or more after initiation of mechanical ventilation. It is the most common hospital-associated infection (HAI) in critically ill adult patients, and is the second most common after bloodstream infection for the paediatric population [2-4]. VAP accounts for about 20% of all HAI among patients in paediatric intensive care unit (PICU) and has a rate of (2.9-21.6)/1,000 ventilator days [5,6]. Furthermore, some data suggested higher mortality rate for mechanically ventilated paediatric patients with VAP compared with those without VAP [7]. Amongst the challenges in any intensive care settings, curtailing nosocomial infections like VAP is an important issue [8,9]. The prevalence of VAP in different setups varies [10-12]. It is important to identify the burden of VAP in any setup, so that prevention strategies can be implemented and strengthened. VAP is not only associated with increased mortality but also increases with the length of ICU stay, the cost of treatment and the chances of ventilator dependence. Various risk factors have been identified that may predispose to the development of VAP [2,13]. The epidemiology, pathogenesis, and outcome of VAP are well described in adults, however, few data exist regarding VAP in paediatric patients [2]. Because of different anatomy, physiology and underlying illnesses from adults, it is important to identify specific prevention for this population in preventing VAP [2,13]. This study was conducted to access the risk factors and to determine the incidence rate, bacteriological profile and antibiotic sensitivity pattern organisms causing VAP in paediatric intensive care unit at the Indira Gandhi institute of Child Health. Materials and Method This was a prospective type of study, after clearance by ethical committee was conducted from January 2015 for 21 months at the Indira Gandhi Institute of Child Health, Bengaluru, Karnataka. Inclusion criteria: Study subjects were patients aged between one month and 16 years in the PICU and subjected to mechanical ventilation for more than 48 hours and showed clinical/radiological evidence of pneumonia along with bacteriological culture showing a significant colony count (≥ 10 5 CFU/ml) as per the Centre for Disease Control and Prevention (CDC) guidelines [14]. Exclusion criteria: Patients already having pneumonia at the time of ICU admission and patients who