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Background: Ventilator-Associated Pneumonia (VAP) is one of the frequent intensive-care-unit (ICU)-acquired infection. The aetiology of VAP varies with patients’ profiles and ICU settings. Due to the increasing incidence of multidrug-resistant organisms in ICUs, early and correct diagnosis of VAP is an urgent challenge for an optimal antibiotic treatment. The aim of the study was to assess the incidence of VAP in different patients by various organisms to create a database of the causative agents of VAP, their drug resistance profile in that area.Methodology: A prospective study was done over a period of 12 months in a rural tertiary care hospital enrolling patients undergoing mechanical ventilation (MV) for >48 h. Samples were collected from patients with suspected VAP, cultures were performed on all samples. VAP was diagnosed by the growth of significant pathogens. Combination disk method, EDTA disk synergy (EDS) test and cefoxitin double disc synergy test were performed for the detection of different patterns of drug resistance.Results: Culture positive cases were 52.29% of total. Acinetobacter spp, Klebsiella pneumoniae and Staphylococcus aureus were most frequent pathogen in early-onset VAP, while Pseudomonas spp. and Acinetobacter spp. dominated the list of pathogens responsible for lateonset VAP. Prior antibiotic therapy and hospitalization of five days or more were independent risk factors for VAP by MDR pathogens.Conclusions: This study highlighted high incidence of VAP in our setup. Production of ESBL, AmpC beta-lactamases and metallo beta-lactamases were responsible for the multi-drug resistance of the pathogens causing VAP, implicating the injudicious use of antimicrobial therapy. Combined approaches of rotational antibiotic therapy and education programs might be beneficial to fight against these MDR pathogens to decrease the incidence of VAP.Bangladesh Journal of Medical Science Vol.15(4) 2016 p.588-595

Bacterial sepsis continues to be a major cause of morbidity and mortality in neonates. The features of sepsis being non- specific, a high index of suspicion can only save a precious life. Pathogens of early onset septicaemia may vary, from one country to another and within a country from one place to the other. This study had been undertaken t o understand the variations in the pathogens of early onset neonatal septicaemia according to birth weights ,their susceptibility patterns to commonly used antibiotics in this age of emerging resistance and to utilise this data for better empirical treatment of this potentially fatal conditions. Blood samples from 255 babies belonging to various birth weights and of both sexes with definitive inclusion and exclusion criteria were processeed according to standard laboratory protocols during a five year period, from February 2005-2010, in a rural referral hospital of West Bengal. Culture positivity was found in 63/255 samples (24.70%), comprising of Klebsiella pneumoniae (31.74%) and methicillin sensitive Staphylococcus aureus (31.74%) as predominant isolates. Male: female ratio was 1.25:1. The susceptibility pattern of isolates has been discussed. It is observed that bacteriology of early onset neonatal septicaemia varies according to birth weights. In very low birth weight babies Eshcherichia coli is the predominant organism and culture positivity is highest (87.5%). Where as culture postivity in low birth weight and normal weight babies with sepsis are 32.89% and 29.26% respectively.In low birth weight babies Staphylococcus aureus and in normal weight babies Klebsiella pneumoniae are the predominant organisms. Birth weight of babies and development of neonatal sepsis are significantly associated x2= 7.174, p