Incidence, Pathogens and Antibiotic Resistance of Nosocomial Pneumonia in Intensive Care Units

Nosocomial pneumonia (NP) is the most frequent infection in intensive care units (ICUs) and has high morbidity and mortality. An important part of this entity develops in patients entubated and mechanically ventilated. The most frequent pathogens are gram-negative bacilli. Despite the usage of broad spectrum antibiotics, NP remains a serious problem in ICUs, because of increasing resistance. This is a prospective study to establish incidence, pathogens, antibiotic sensitivity and mortality of NP in ICU. Patients with NP, older than 16 years old, in the ICUs were included to study. The isolated pathogens, antibiotic sensitivity and mortality of these patients were recorded. NP developed in 231 (54 per 1000 patients admitted to the ICUs) patients of 4254. 175 (75.8%) of these cases were ventilator associated pneumonia (VAP). 305 pneumonia episodes were seen in 231 patients. The most frequent microorganisms were Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus. The resistance rate of these pathogens were very high. The mortality rate was 69.7%. NP is the most frequent nosocomial infection in ICUs. The incidence have been reported 7-27% and 0.8-12.5 per 1000 patient days in several studies. In our study, the incidence was 54 per 1000 patients admitted to the ICUs. The most frequent microorganisms are gramnegative bacilli in NP. Also in this study, the most frequent pathogens were A. baumannii, P. aeruginosa and K. pneumoniae. In these pathogens, the resistance rates were very high. The severity of illness, the duration of hospital stay and inappropriate antibiotic usage are related with high antibiotic resistance rates. As the pathogens were highly resistant gram-negative bacteria, the mortality was very high in our study