A prospective study of ventilator-associated tracheobronchitis: Incidence and etiology in intensive care unit of a tertiary care hospital.

CONTEXT: Ventilator-associated tracheobronchitis (VAT) is an infective complication of mechanical ventilation and is a part of the spectrum of ventilator-associated respiratory infections. In the Intensive Care Units (ICUs), VAT is a relatively common problem but in comparison to ventilator-associated pneumonia (VAP), much less data are available on VAT and its management.

MATERIALS AND METHODS: Patients ventilated for more than 48 hours were screened daily for the development of VAT. Patients were followed up daily until they were extubated, died or discharged from the hospital. The patient demographics, underlying condition, causative organism and resistance patterns were observed.

RESULTS: 13.2% of patients developed VAT. The majority patients who developed VAT had underlying neurological problems. The mean time to develop VAT from the time of mechanical ventilation was 7.3 days and from time of ICU admission was 10 days, respectively. Multidrug-resistant (MDR) Acinetobacter sp. and Pseudomonas aeruginosa were the most frequently isolated organisms.

CONCLUSIONS: VAT is a common healthcare-associated infection caused mostly by MDR Gram-negative bacteria. Monitoring and active surveillance are required to detect VAT at the earliest to institute appropriate isolation measures and therapy.