Abstract

The care of critically ill patients in the hospitals is a primary component of modern medicine. Nosocomial infection may develop during hospital stay .Upper air way protect the lower respiratory tract from invasion by pathologic bacteria, but after tracheostomy this protective mechanism has been bypassed. This study was conducted in tracheostomized patient 50 in number. Bronchoalveolar lavage was done on 3rd day of tracheostomy and lavage fluid was sent for the culture and sensitivity in sterile container. Total number of patient was 50 from age of 2yr to 72 yr with male 36 and female 14. 52% samples were positive and 48% were negative. Most common Organism isolated were Pseudomonas 42.30%, Klebsiella 19.23%, Streptococcus15.3%, Staphylococcus11.53%, Proteus11.53%. Sensitivity was as follows Pseudomonas –Ciprofloxacin 55%R28%S, Gaityfloxacin 45%S55%R, Gentamycin 36%64%R, Amikacin 19%S73R, Cefotaxim 18%S82%R, Ceftrixone+salbactam 55%S45%R, Pipearacillin+tazobactum 73%S27R. Klebsiella-Ciprofloxacine 100%R, Gaityfloxacin 100%R, Gentamycin 100%R, Amikacin100%R, Cefotaxim40%S60%R, Ceftriaxone+salbactam 60%S40%R, Piperacillin+tazobactum 60%S40%R. Streptococcus- Ciprofloxacin 25%S75R, Gaityfloxacin 75%25%R, Gentamycin100%R, Amikacin 100%R, Cefotaxim 100%R Ceftriaxon+salbatam 100%R, Piperacillin+tazobatum 50%S50%R, Staphylococcus- Ciprofloxacine 100%R, Gaityfloxacin 33%S66%R, Gentamycin 100%R, Amikacin 100%R, Cefotaxim 100%R, Ceftriaxone+salbactam 66%S33%R, Piperacillin+tazobactum 66%S33R. Proteus- Ciprofloxacine 100%R, Gaityfloxacin 50%S50%R, Gentamycin 100%S, Amikacin 100%R, Cefotaxim 100%R, Ceftriaxone+salbactam 50%S50%R, Piperacillin+tazobactum 100%S. After analyzing the results, source of infection is seems to exogenous as normal flora of oral cavity are Streptococcus, Neisseria, Anaerobe, Candida albicans. Keywords: Nosocomial infection, tracheostomy, Antibiotics

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