VENTILATOR-ASSOCIATED PNEUMONIA IN THE INTENSIVE CARE UNIT OF SURGICAL EMERGENCY TEACHING HOSPITAL IN SULAIMANI CITY

Ventilator-associated pneumonia (VAP) is a common nosocomial infection with high mortality in intensive care units. The aim of this study was to determine the prevalence of VAP in Sulaimani Surgical Emergency Teaching Hospital, and examine the frequency of pathogens with their susceptibility patterns. A group of 152 patients on mechanical ventilation and a control group of 65 patients were selected from the Intensive care unit of Sulaimani Surgical Emergency Teaching Hospital/Iraq over a period of one year (from October 2019 to February 2020). Both groups were followed for the development of pneumonia. Culturing, identification and susceptibility testing of pathogens was performed at the Microbiology Department of Public Health Laboratory. The incidence of VAP was 80.9% in the ventilated patient group. Males had a higher incidence than females (ratio 3:1), and patients between 30-40 years were the most affected age group, having been admitted predominantly after traffic accidents. Among pathogens, gram-negative bacteria were the most frequent causative agents (93.3%), notably Acinetobacter baumannii (43.3%). Among Gram-positive bacteria only, Staphylococcus aureus was frequently present (17.8%). Acquired resistance was exceedingly high, especially in the non-fermenting group of gram negatives. The incidence of VAP is very high among ICU patients in Sulaimani city predominantly affecting males in the 31-40 year age group. VAP is mostly caused by gram-negative infections (especially Acinetobacter baumannii); gram positives are not uncommon, including methicillin sensitive staph. aureus as most common agent of VAP. Multidrug resistant bacteria are common and account for near 40% of all VAP agents.