Ventilator Associated Pneumonia (VAP) is defined as pneumonia that occurs 48 hours or more after endotracheal intubation or tracheostomy, caused by infectious agents not present or incubating at the time mechanical ventilation started. While critically ill patients experience a life-threatening illness, they commonly contract ventilator-associated pneumonia. This nosocomial infection increases morbidity and likely mortality as well as the cost of health care. This study aims to find out the bacterial profile of VAP in geriatric patients and the antibiotic susceptibility pattern of the isolated pathogen including detection of MRSA, ESBLs and MBLs. This study was conducted in the Department of Microbiology at ESIC MC and PGIMSR, Rajajinagar, Bengaluru from January 2017 to June 2018. A total of 38 isolates from 35 VAP patients were collected during the study. They were processed following standard laboratory protocol. Antibiogram was done using appropriate antibiotics by Kirby-Bauer disc diffusion method and the occurrence of MRSA, ESBLs and MBLs was seen. Males were most common male to female ratio of 2:1.Acinetobacter spp. (45.5%) was most common organism isolated followed by Pseudomonas aeruginosa (24.2%), Klebsiella pneumoniae (21.2%), Staphylococcus aureus (15.2%) and Escherichia coli (9%). Enterobacteriaceae isolated were found to be highly sensitive to Amikacin (30%) followed by Gentamicin (20%) and Piperacillin-tazobactam (10%) and Highest resistance (100%) was seen with Cefotaxime, Cefoperazone, Cotrimaxazole, Piperacillin and Amoxiclav. Non-fermenters showed highest sensitivity to Cefperazone-sulbactum (73.9%), followed by Amikacin (60.9%) and Meropenem (52.2%), Highest resistance was seen with Cefotaxime (86.9%) followed by Cefperazone (78.3%) and Ceftazidime (73.9%). Overall MDR among Gram negative isolates were 31.6% and common mechanism of resistance was found to be Carbapenamase (57.6%), followed by AmpC (18.2%), and ESBL (3.03%). Among Carbapenamase Metallo-betalactamase production was seen in 18.2% of isolates. MRSA was detected to be 40% and were sensitive to Linezolid, Tetracycline and Teicoplanin. Diabetes mellitus (54.3%) was most common risk factor, followed by smoking (51.4%), and alcohol (45.7%). 88% of patients had leucocytosis with mean total leucocytosis count (TLC) of 17,348 cells/mm3 and 17% of patients were anaemic with mean Hb of 10.02g/dl and 45.7% of patients had pneumonic changes (consolidation) and 51.4% of patients had BL/UL alveolar or interstitial infiltration. Periodic analysis of Sputum culture and their antibiotic sensitivity report should be made to identify the changing trends in etiological and sensitivity patterns.

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