Browsing by Author "Gilya, Michael"

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    Ventilator associated pneumonia among adult patients in intensive care units at Muhimbili
    (Kairuki University, 2025) Gilya, Michael
    Background: Ventilator-associated pneumonia (VAP) is a serious nosocomial infection affecting patients undergoing mechanical ventilation, especially in intensive care units (ICUs). The increasing prevalence of multidrug-resistant (MDR) organisms complicates management and worsens patient outcomes, particularly in low-resource settings. Objective: This study aimed to determine the bacteriological profile, antimicrobial resistance patterns, and associated risk factors of VAP among mechanically ventilated patients in three public tertiary hospitals in Dar es salaam, Tanzania. Methods: A hospital-based cross-sectional study was conducted at Muhimbili (MNH, JKCI, and MOI). ICUs Patients who were mechanically ventilated for ≥48 hours were evaluated for VAP using the Clinical Pulmonary Infection Score (CPIS ≥6). Endotracheal aspirates were cultured, and antimicrobial susceptibility testing (AST) was performed using the Kirby-Bauer disc diffusion method following CLSI guidelines. Data were analyzed using SPSS, and logistic regression was applied to identify factors associated with VAP. Results: Among 119 patients, 52(43.7%) were diagnosed with VAP. Among these 52 cases, the predominant bacterial isolates were Pseudomonas aeruginosa 15(28.8%), E. coli 10(19.2%), Klebsiella pneumoniae 7(13.5%), Acinetobacter spp. 6(12%), and Staphylococcus aureus 9(17.3%). Over 69.5% of isolates exhibited multidrug resistance, especially against cephalosporins, fluoroquinolones, and aminoglycosides. Age was identified as an independent predictor of VAP in the adjusted analysis. Conclusion: This study reveals a high VAP burden and MDR prevalence in Tertiary Hospitals ICUs, highlighting the need for strengthened infection prevention, empirical therapy review, and robust antimicrobial stewardship policies.