A Study on Microbiological and Antibiotic Susceptibility Profile of Endotracheal Aspirate in Patients Suspected of Ventilator-Associated Pneumonia in a Tertiary Care Hospital
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 10
Abstract
Background: Respiratory infections in critically ill patients are associated with high morbidity and mortality. Patients who are mechanically ventilated are at high risk of acquiring respiratory tract infections due to a complex interplay between the endotracheal tube, host immunity, and virulence of invading bacteria. To initiate empiric antimicrobial therapy knowledge of local antimicrobial resistance patterns are essential. Aim: The aim of our study was to identify the bacterial pathogens and their antibiotic susceptibility of endotracheal aspirate samples collected from the patients on mechanical ventilation for more than 48 hours. Materials and Methods: This prospective study was done at Saveetha Medical College and Hospital, Chennai. One hundred and seven samples were collected, bacteriological identification and antibiotic susceptibility were tested for pathogen grown in endotracheal cultures received. Results: Culture was positive in sixty-one out of one hundred and seven samples (i.e., 57% of all the samples) out of which gram-negative bacteria accounted for (59 out of 61) 96.72% cases and rest 2 cases were Candida spp. Pseudomonas spp 37% (22 out of 61) was the commonest organism isolated followed by Klebsiella spp 33% (20 out of 61), Acinetobacter spp 20% (12 out of 61), Escherichia coli 3.3% (2 out of 61), Enterobacter spp 3.3% (2 out of 61) and Proteus spp 1.6% (1 out of 61). ESBL rate was highest among Acinetobacter spp (100%) followed by Klebsiella spp (40%) and Pseudomonas spp (27%). Most of the Acinetobacter spp 83% (10 out of 12) were Multidrug-resistant whereas five isolates of each of Klebsiella spp (25%) and Pseudomonas spp (23%) were found to be MDR and sensitive to only colistin and tigecycline. Fungal isolates consisted of one case of Candida albicans and Candida non-albicans each. Conclusion: Gram-negative bacteria especially Pseudomonas spp, Klebsiella spp, Acinetobacter spp are most commonly encountered pathogens isolated in endotracheal samples of ventilator-associated pneumonia patients. Among these pathogens, Acinetobacter spp. shows very high ESBL positivity, while these characteristics are moderately expressed in Klebsiella spp and less commonly in Pseudomonas spp. Multidrug resistance also followed the same trail among these common pathogens.
Authors and Affiliations
Dr Debjita Debnath
Keywords
Related Articles
- EP ID EP513955
- DOI -
- Views 99
- Downloads 0
A Comparative Study of two Doses of Intrathecal Clonidine with Hyperbaric Bupivacaine in Elective Lower Abdominal and Lower Limb Surgeries
Introduction: For lower limb and lower abdominal surgeries, the standard anaesthetic technique is subarachnoid block. Adrenaline being the first spinal adjuvant used to increase the duration and to reduce the toxicity of...
A Review on Recent Advances in Drug Development and Pharmacotherapeutic Approaches for Obesity
Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. A crude population measure of obesity is the body mass index (BMI) . A person with a BMI of 30 or more is gener...
Fracture Neck of Femur Treated with Hemiarthroplasty and its Functional Out Come.
Objective; To document the functional outcome of fracture neck of femur treated with hemiarthroplasty using HHS,KATZ-ADL,TUG-Test and Gait speed. Methodology; Patients with neck of femur fracture admitted in the RMMC&H b...
Study of Correlation of Retinal Layer Thickness with Duration and Severity of Parkinson’s Disease
PD is primarily a motor disorder associated with loss of dopaminergic neurons. Dopamine (DA) is also a major neurotransmitter in the retina. There is concurrent retinal DA neurons loss in in the inner nuclear &inner plex...
Adolescent Health Programs in Gujarat State- A Case Study
Adolescence is a fascinating period of life that marks the transition from being a dependent child to become an independently functioning adult. The health needs of adolescents have seldom been addressed in developing co...