Background
Ventilator-associated pneumonia (VAP) is defined as
pneumonia that develops 48 hours or more after endotracheal intubation or
tracheostomy and is brought on by infectious organisms that are not present or incubating during
mechanical ventilation. Multidrug-resistant organisms originate primarily from the hospital environment and significantly contribute to
ventilator-associated pneumonia. These organisms pose a severe threat, leading to a higher mortality rate due to their resistance to more potent
antibiotics. Methods The study aims to assess the efficacy of the modified Carba NP test in detecting
carbapenemase-producing bacteria in geriatric VAP patients. Results Forty (38 gram-negative and 2 gram-positive) pathogens were isolated from VAP patients. The isolates were identified using standard laboratory protocol; Acinetobacter spp. (n=16; 40% ), followed by Klebsiella pneumoniae (n=13; 32.5%), is the most common organism isolated. Seventeen (44.73%) were multi-
drug resistant gram-negative bacteria. The
carbapenemase producers were detected by the Kirby-Bauer disc diffusion method and compared with the modified Carba NP test with a turnaround time of 12-18 hrs in comparison to the disk diffusion test which requires additional 12hrs.
Carbapenemase production was seen in 12 (70.59%) MDR isolates (7-Acinetobacter spp, 3-Klebsiella
pneumonia, 1-Escherichia coli, and 1-Pseudomonas aeruginosa). Conclusion Modified Carba NP can be used as a rapid test to detect
carbapenemase production, and it can replace the traditional disk diffusion method of detecting
carbapenemase production. This test plays a crucial role in the management of critical patients by saving 12-18 hours to determine the most appropriate and effective
antibiotic treatment. This timely decision is essential in preventing
sepsis caused by localized
infections.