DOI: 10.21276/aimdr.2017.3.4.MB2 Original Article ISSN (O):2395-2822; ISSN (P):2395-2814 Annals of International Medical and Dental Research, Vol (3), Issue (4) Page 6 Section: Microbiology Prospective Observational Study of Ventilator Associated Pneumonia in Pediatric Intensive Care Unit in a tertiary care hospital, New Delhi. Meenakshi Sharma 1 , Manoj Jais 2 , Rajesh Ranjan 3 , Virendra Kumar 4 , Mitasha Singh 5 , Amit Marwah 6 1 PG Student, Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi. 2 Professor, Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi. 3 Associate Professor, Department of Community Medicine, ESIC Medical College and Hospital, Faridabad, Haryana. 4 Director Professor, Department of Pediatrics, Lady Hardinge Medical College and Associated Hospitals,New Delhi. 5 Assistant Professor, Department of Community Medicine, ESIC Medical College and Hospital, Faridabad, Haryana. 6 Adjunct Professor, Department of Centre for Translational and clinical research and Dept. of Pharmacology, Faculty of Pharmacy, Jamia Hamdrad. Received: May 2017 Accepted: June 2017 Copyright: © the author(s), publisher. Annals of International Medical and Dental Research (AIMDR) is an Official Publication of “Society for Health Care & Research Development”. It is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non- commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Ventilator associated pneumonia (VAP) is defined as nosocomial pneumonia in mechanically ventilated patients that develops more than 48 hrs after initiation of mechanical ventilation. The study was done to determine the incidence of VAP in pediatric patients undergoing mechanical ventilation and to identify the common microbes incriminated in causing VAP in patients admitted and put on mechanical ventilation. Methods: This study is the prospective and observational study done from December 2010 – January 2012. The aim of the study was to find out a) the incidence of ventilator-associated pneumonia in pediatric intensive care unit and b) the bacteria responsible for VAP and their antibiotic sensitivity pattern. Data will be coded and analyzed by using SPSS version 12 or 16. Statistical analysis was done by using Student’s paired t-test for quantitative and Chi-square test for qualitative parameters. The p value of <0.05 was considered as statistically significant. Results: Incidence of VAP in terms of per 1000 ventilator days was 26.13/1000. Out of the 103 study group patients 43 (41.74%) were culture positive with significant bacterial counts but only 31 (30%) patients were diagnosed as VAP as per the inclusion criteria. Of 31 patients diagnosed as VAP, 22 (70.96%) patients had infection with single organism and 9 (29.03%) had polymicrobial infection. The most common isolate was Acinetobacter (37.5%) followed by Pseudomonas and Klebsiella (27.5%). Among the polymicrobial infection Acinetobacter along with Klebsiella and Pseudomonas was the common combination seen. Conclusion: The role of microbiology in VAP is to identify the organisms commonly responsible for causing VAP and to know the antibiotic resistance pattern of these organisms. This will help the clinicians in formulating a proper empirical and therapeutic strategy against the causative organisms of VAP. Keywords: Micro-organism, Pediatric, Ventilator associated pneumonia. INTRODUCTION Intensive care units have come to represent the most frequently identifiable source of nosocomial infections within the hospital, with the infection rates and rate of antimicrobial resistance several fold greater than the general hospital setting. [1] Ventilator associated pneumonia (VAP) is defined as nosocomial pneumonia in mechanically ventilated patients that develops more than 48 hrs after initiation of mechanical ventilation. [2] ventilator associated pneumonia is divided into early onset pneumonia which occurs in 5 days of mechanical ventilation and late onset pneumonia which develops five or more days after initiation of mechanical ventilation. The importance of segregating VAP in early and late onset is that, the pathogenesis, microorganisms responsible and outcome in these groups are different and so the therapeutic implications also differ. [1] Early onset VAP, which occurs within the first five days of mechanical ventilation, usually is less severe, associated with better prognosis, and is more likely to be caused by antibiotic sensitive bacteria. Late onset VAP, which develops five or more days after initiation of mechanical ventilation, is caused by multidrug resistant (MDR) pathogens and is associated with increased morbidity and mortality. [3] Diagnosis of VAP is made by clinical criteria by National Nosocomial Infection Surveillance (NNIS) for pediatric patients. [4] Diagnosis of VAP can be made on the basis of radiographic findings, clinical findings, results of microbiological tests. The likelihood of VAP increases if a patient has clinical signs and symptoms such as fever, leukocytosis, and purulent sputum in addition to abnormal findings on chest radiographs.