Study of Clinical Profile, Management, and Outcomes of Ventilator-Associated Pneumonia in an Intensive Care Unit at a Tertiary Care Centre

Background: Ventilator-associated pneumonia (VAP) is a major healthcare-associated infection among critically ill patients receiving invasive mechanical ventilation. The increasing prevalence of antimicrobial-resistant pathogens complicates treatment and underscores the importance of institution-specific microbiological surveillance. This study evaluated the clinical characteristics, microbiological profile, antimicrobial resistance patterns, treatment modifications, and clinical outcomes of patients with VAP in a tertiary-care medical intensive care unit (ICU). Methods: A prospective, hospital-based descriptive observational study was conducted in the medical ICU of Government Medical College and Hospital, Chhatrapati Sambhajinagar, Maharashtra, India, from January to December 2025. A total of 120 adult patients who developed VAP after more than 48 hours of invasive mechanical ventilation were included. Demographic and clinical characteristics, respiratory culture results, antimicrobial susceptibility patterns, treatment modifications, duration of mechanical ventilation, ICU length of stay, complications, and ICU outcomes were assessed. Categorical variables were summarized as frequencies and percentages, while continuous variables were expressed as mean ± standard deviation or median and interquartile range, as appropriate. Results: The mean age of the 120 patients was 55.8 ± 16.2 years, and 68.33% were male. Late-onset VAP occurred in 58.33% of patients. Respiratory cultures were positive in 108 patients (90.00%), yielding 118 bacterial isolates, of which 91.53% were Gram-negative organisms. Acinetobacter baumannii (33.90%), Klebsiella pneumoniae (26.27%), and Pseudomonas aeruginosa (18.64%) were the predominant isolates. Multidrug resistance and extensive drug resistance were identified in 66.95% and 27.12% of isolates, respectively. Carbapenem resistance was observed in 80.00% of A. baumannii, 67.74% of K. pneumoniae, and 50.00% of P. aeruginosa isolates. Antimicrobial therapy was modified following microbiological results in 70.00% of patients. The median ICU stay was 15 days (IQR 10–22), and ICU mortality was 38.33%. Conclusion: VAP in this tertiary-care ICU was predominantly associated with Gram-negative bacteria and a substantial burden of antimicrobial resistance. These findings highlight the importance of local microbiological surveillance, appropriate respiratory sampling, culture-guided antimicrobial modification, and antimicrobial stewardship to support the management of VAP.