Antimicrobial Resistance Pattern of Bacterial Isolates from Endotracheal Aspirate of Ventilated Patients at a Tertiary Care Hospital
Background: Respiratory infections among critically ill Patient are associated with high morbidity and mortality. Mechanically ventilated patients are at a high risk of acquiring respiratory infections due to complex interplay between the endotracheal tube, host immunity and virulence of invading bacteria. Irrational use of antibiotics increases the emergence of drug resistant bacteria. Objectives: The aim of study was to investigate the bacterial isolates in the endotracheal aspirates of mechanically ventilated patients in ICU and see the antimicrobial resistance pattern of bacterial isolates. Methods: Analysis of E.T aspirates of 459 patients over a period of 1 year (Aug 14 to Aug 15) was done. Aspirates were cultured on Blood and MacConkey agar isolation and identification was done using conventional techniques and biochemical reactions. Antibiotic sensitivity testing was done by Kirby-Bauer disc diffusion method as per CLSI guidelines. Results: Out of 459 Samples 365 was found to be positive. Acinetobacter sp (44.65%) was the most common isolate followed by Klebsiella sp (18.63%), Pseudomonas sp (11.23%), Candida (10.46%), Escherichia Coli (7.94%), COPS (3.28%), CONS (2.46%), Enterococci (0.82%), and Citrobacter (0.54%). The gram-negative bacilli were mostly sensitive to Tigecycline, Colistin, Imipenem, Meropenem, Amikacin and Piperacillin/Tazobactam. Gram positive Cocci were mostly sensitive to Vancomycin, Linezolid and Gentamicin.
Conclusion: The isolation and antimicrobial resistance pattern of the microorganisms is necessary for their effective management. Endotracheal intubation is one of the major risk factors in causing iatrogenic infections to patients. A local antibiogram for each hospital, based on bacteriological patterns and susceptibility is essential to initiate empirical therapy.
2. Alain CJ, Dominador GM, Gemma BR, Michael AD, Christine TG. Review on the antimicrobial resistance of pathogens from tracheal and endotracheal aspirates of Patients with clinical manifestations of Pneumonia in Bacolod city in 2013.Intl J Bact 2015; 5(8): 1-5.
3. Joao M, Ederlon R. Epidemiological and microbiological analysis of ventilator-associated pneumonia patients in a public teaching hospital. Brazl J infect dis 2007; 11(5):482-8.
4. Cinical and Laboratory Standards Institute. 2014. Performance Standards for Antimicrobial Susceptibility Testing; 17th informational supplement. CLSI document M100-S17(ISBN 1- 56238-625-5) Clinical and Laboratory Standards Institute USA
5. Anusha N, Madhu KP, Arun BJ, Vidyasagar B. Microbiological profile and sensitivity pattern of endotracheal secretions in mechanically ventilated patients in ICU. J Evi Med Health 2014; 1(9):1177-84
6. Shanmugavadivoo N, P Santharam, Sudha K, Kalaiselvi G, Padmavathi BK, Usha B, et al. Dynamic bacterial profile of endotracheal aspirates and its sensitivity pattern –A Cause of Concern. Int J Cur Res Rev 2014; 6(10):112-19.
7. BhaskarThakuria, Preetinder Singh, Sanjay Agrawal, Veena Asthana, “Profile of infective microorganisms causing ventilator associated pneumonia: A clinical study from resource limited intensive care unit”, Journal of Anaesthesiology Clinical Pharmacology. July-September 2013; Vol 29 Issue 3:361-366.
8. Vimal Shriram Rathod1, Rohit Sinha2, Vijay Rajaram Shegokar3, Bhausaheb Anil Munde4, Khan Saleha2 Bacteriological Profile and Antibiogram of Endotracheal Aspirates in Intubated Patients at a Tertiary Care HospitalInternational Journal of Health Sciences & Research (www.ijhsr.org) 82 Vol.8; Issue: 5; May 2018
9. Santosh Khanal, Dev Raj Joshi, Dwij Raj Bhatta, UpendraDevkota, and Bharat Mani Pokhrel, “
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