Bacteriological Profile and Antibiogram of Endotracheal Aspirates in Intubated Patients at a Tertiary Care Hospital

Gupta Veetheeanveshana; Chaudhary Anuradha; Tamarkar Meenakshi; Rana Aditya; Jaryal S.C.; Sood Anuradha

Volume : IX, Issue : XII, December - 2019

Bacteriological Profile and Antibiogram of Endotracheal Aspirates in Intubated Patients at a Tertiary Care Hospital

Gupta Veetheeanveshana, Chaudhary Anuradha, Tamarkar Meenakshi, Rana Aditya, Jaryal S. C. , Sood Anuradha

Abstract :

Background: Endotracheal intubation is a life–saving procedure, but it is associated with a high risk of acquiring respiratory infections. 1Several factors like new mutations, selection of resistant strains and suboptimal infection control along with the use high level antibiotics influences the rapid spread of extensively drugs resistant bugs in these intubated patients.. These infections are associated with significant rise in morbidity, mortality and healthcare cost.2,3 It is very essential for the clinicians to be aware of local bacteriological flora and their susceptibility pattern to encourage rational use of antibiotics. Aim: The aim of our study was to present a data that represents the local bacterial trend in respiratory secretions of the ventilated patients and their antibiotic susceptibility patterns in this tertiary care centre. Materials and Methods: This was a retrospective descriptive analytic study of endotracheal (ET) samples of patients on mechanical ventilation done over a period of 2 years from January2017 to December 2018 .This was done to analyse bacteriological profile and their antibiotic susceptibility. Analysis of Endotracheal Aspirates of 110 intubated patients were cultured on Blood, MacConkey and Chocolate 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 110 samples 98(89%) were culture positive. 35 cases were found to be polymicrobial. 12 samples showed no growth. Extensively drug–resistant (XDR) Acinetobacter baumannii was the most common organism (20.3.%), and it had occurred endemically throughout the year. Pseudomonas aeruginosawas the next most common organism (18.8%). In Enterobacteriaceaefamily Citrobacter spp.(13.2%) ,Klebsiella sp.(11%) E. coli (7.6%) were the most common detected isolates. Amongst gram positive bacteria S. aureus (15.3%) and CoNS (4.8%) were commonly detected. Most isolates of Acinetobacter spp. were multi drug resistant and showed sensitivity to imipenem and Colistin only. The gram Negative bacilli were mostly sensitive to Imipenem, Meropenem, Cefoperazone plus sulbactum, Piperacillin Tazobactam. The Gram Positive cocci were mostly sensitive to Vancomycin and Linezolid. Conclusion: Endotracheal intubation is a major risk factor in causing iatrogenic infections to patients which lead to an increase in the morbidity and mortality. Knowledge of local bacteriological trend of the antibiotic susceptibility pattern is a must to initiate a judicious antibiotic treatment.