Year: 2024 | Month: May | Volume: 14 | Issue: 5 | Pages: 331-338
DOI: https://doi.org/10.52403/ijhsr.20240543
Ventilator Associated Pneumonia and Its Correlation with Oral Cavity Bacteria
Jyoti Shamrao G1, Dr. A. D. Urhekar2
1Tutor, Department of Microbiology, MGM Medical College and Hospital Kamothe, Navi Mumbai, Maharashtra, India.
2Emeritus Professor, Department of Microbiology, MGM Medical College and Hospital Kamothe, Navi Mumbai, Maharashtra, India.
Corresponding Author: Jyoti Shamrao G
ABSTRACT
Introduction: Ventilator-associated pneumonia (VAP) is a critical concern in intensive care units (ICUs), defined as pneumonia occurring within 48 hours of intubation and mechanical ventilation. It is often linked to prolonged hospital stays and poses a significant threat to patient well-being. Diagnosis of VAP relies on a set of criteria, including clinical symptoms, radiological evidence, and bacteriological confirmation, with the caveat that these signs were absent upon initiation of ventilation.
Aim: This study aims to investigate the potential correlation between oral/mouth flora and their role as causative pathogens in VAP among patients in tertiary care units.
Material and Methods: This is a Retrospective study conducted in Department of Microbiology, MGM Medical College and Hospital Kamothe, Navi Mumbai from August 2019 to December 2020. Patients on ventilator admitted in MICU, SICU and EMS ICU were included in the study. Endotracheal tube aspirate/ Endotracheal tube tip and oral secretions of the patient diagnosed with VAP were collected with aseptic precautions using sterile material. Samples were transported to laboratory as soon as possible OR stored in refrigerator at 2℃ to 8℃. Examination of bacterial flora in the oral/mouth cavity of patients using standard microbiological techniques by collecting oral swabs. Statistical r value was calculated to establish relationship between oral cavity bacteria and VAP causing bacteria.
Results:
•Culture of ET tip showed maximum presence of klebsiella 24% followed by Acinetobacter 23% pseudomonas spp, Citrobacter spp and staph aureus.
•Bacteriological culture of oral secretion showed klebsiella 16%, Acinetobacter 11%, Staph aureus 18% and CONS
•The number of patient’s samples having similar bacterial pathogens in ET tip and Oral secretion were 76%
•The calculated correlation coefficient (r value) for the two sets of data is 0.372. which is considered to be statistically significant.
Conclusion: This study underscores the significant proof that in majority of cases, bacteria in oral cavity gain access to lower respiratory and causes VAP development. While further research is needed to fully elucidate the mechanisms involved, our findings suggest a potential link between oral pathogens and VAP. Understanding this connection may offer new insights for the prevention and management of VAP, ultimately improving patient outcomes in ICUs.
Key words: Oral Bacteria, Endotracheal Tube, Respiratory Pathogens, Ventilator Associated Pneumonia.