TY - JOUR
T1 - Surveillance of ventilator associated pneumonia in a network of indian hospitals using modified definitions
T2 - a pilot study
AU - Mathur, Purva
AU - Ningombam, Aparna
AU - Soni, Kapil Dev
AU - Aggrawal, Richa
AU - Singh, Kumari Vandana
AU - Samanta, Projoyita
AU - Gupta, Stuti
AU - Srivastava, Smriti
AU - Behera, Bijayini
AU - Tripathy, Swagata
AU - Ray, Pallab
AU - Biswal, Manisha
AU - Rodrigues, Camilla
AU - Bhattacharya, Sanjay
AU - Mukherjee, Sudipta
AU - Mukherjee, Satyam
AU - Venkatesh, Vimala
AU - Verma, Sheetal
AU - Arshad, Zia
AU - Tak, Vibhor
AU - Bhatia, Pradeep Kumar
AU - Nag, Vijaylakshmi
AU - Karuna, Tadepalli
AU - Saigal, Sourabh
AU - Sharma, Jai Prakash
AU - Singh, Sanjeev
AU - Mukhopadhyay, Chiranjay
AU - KE, Vandana
AU - Varma, Muralidhar
AU - Majumdar, Tapan
AU - Deotale, Vijayshree
AU - Attal, Ruchita
AU - Iravane, Jyoti
AU - Harbade, Mangala
AU - Omkari, Amruta
AU - Walia, Kamini
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/9
Y1 - 2024/9
N2 - Background: Ventilator-associated pneumonia (VAP) is a major cause of morbidity and mortality in patients receiving mechanical ventilation in India. Surveillance of VAP is essential to implement data-based preventive measures. Implementation of ventilator-associated events (VAE) criteria for surveillance has major constraints for low resource settings, which can lead to significant underreporting. Surveillance of VAP using common protocols in a large network of hospitals would give meaningful estimates of the burden of VAP in low resource settings. This study leverages a previously established healthcare-associated infections (HAI) surveillance network to develop and test a modified VAP definition adjusted for Indian settings. Methods: In this observational pilot study, thirteen hospitals from the existing HAI surveillance network were selected for developing and testing a modified VAP definition between February 2021 and April 2023. The criteria used for diagnosing VAP were adapted from the CDC's Pediatric VAP definition and modified to cater to the needs of Indian hospitals. Designated nurses recorded each VAP event in a case report form (CRF) and also collected denominator data. The data was entered into an indigenously developed database for validation and analysis. At the time of data analysis, a questionnaire was sent to sites to get feedback on the performance of the modified VAP definitions. Findings: Out of 133,445 patient days and 40,533 ventilator days, 261 VAP events were recorded, with an overall VAP rate of 6.4 per 1000 ventilator days and a device utilization ratio (DUR) of 0.3. A total of 344 organisms were reported from the VAP events. Of these, Acinetobacter spp (29.6%, 102) was the most frequent, followed by Klebsiella spp (26.7%, 92). Isolates of Acinetobacter spp (98%) and Enterobacterales (85.5%) showed very high resistance against Carbapenem. Colistin resistance was observed in 6% of Enterobacterales and 3.2% of Acinetobacter spp. Interpretation: Data from this pilot study needs to validated in the larger Indian HAI surveillance network so that it can help in wider implementation of this protocol in order to assess its applicability p VAP across India. Funding: This work was supported by a grant received from the Indian Council of Medical Research ( code I-1203).
AB - Background: Ventilator-associated pneumonia (VAP) is a major cause of morbidity and mortality in patients receiving mechanical ventilation in India. Surveillance of VAP is essential to implement data-based preventive measures. Implementation of ventilator-associated events (VAE) criteria for surveillance has major constraints for low resource settings, which can lead to significant underreporting. Surveillance of VAP using common protocols in a large network of hospitals would give meaningful estimates of the burden of VAP in low resource settings. This study leverages a previously established healthcare-associated infections (HAI) surveillance network to develop and test a modified VAP definition adjusted for Indian settings. Methods: In this observational pilot study, thirteen hospitals from the existing HAI surveillance network were selected for developing and testing a modified VAP definition between February 2021 and April 2023. The criteria used for diagnosing VAP were adapted from the CDC's Pediatric VAP definition and modified to cater to the needs of Indian hospitals. Designated nurses recorded each VAP event in a case report form (CRF) and also collected denominator data. The data was entered into an indigenously developed database for validation and analysis. At the time of data analysis, a questionnaire was sent to sites to get feedback on the performance of the modified VAP definitions. Findings: Out of 133,445 patient days and 40,533 ventilator days, 261 VAP events were recorded, with an overall VAP rate of 6.4 per 1000 ventilator days and a device utilization ratio (DUR) of 0.3. A total of 344 organisms were reported from the VAP events. Of these, Acinetobacter spp (29.6%, 102) was the most frequent, followed by Klebsiella spp (26.7%, 92). Isolates of Acinetobacter spp (98%) and Enterobacterales (85.5%) showed very high resistance against Carbapenem. Colistin resistance was observed in 6% of Enterobacterales and 3.2% of Acinetobacter spp. Interpretation: Data from this pilot study needs to validated in the larger Indian HAI surveillance network so that it can help in wider implementation of this protocol in order to assess its applicability p VAP across India. Funding: This work was supported by a grant received from the Indian Council of Medical Research ( code I-1203).
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U2 - 10.1016/j.lansea.2024.100450
DO - 10.1016/j.lansea.2024.100450
M3 - Article
AN - SCOPUS:85198719521
SN - 2772-3682
VL - 28
JO - The Lancet Regional Health - Southeast Asia
JF - The Lancet Regional Health - Southeast Asia
M1 - 100450
ER -
