Abstract :
Introduction: Healthcare associated pneumonia (HAP)is second most common HCAIs that occur in 27% critically ill patients. Eighty-six percent of HAP are associated with mechanical ventilation and termed as ventilator associated pneumonia (VAP). VAP due to multidrug resistant Acinetobacter baumannii has also increased in recent past.
Objective: To isolate and identify the bacterial pathogens in endotracheal tubes aspirates of ICUs patients and study their antimicrobial susceptibility pattern.
Materials and Methods: A prospective longitudinal study was conducted in the Microbiology laboratory
of a tertiary care hospital over a period of six months after clearance from institutional Research Committee and Ethical Committee. All the samples of ETT secretions received in Clinical Microbiology lab from ICU patients and fulfilling the criteria for VAP were included in this study. Samples were processed as per standard protocol and organisms were identified on the basis of gram staining, colony characters and biochemical tests. Antibiotic sensitivity was performed by Kirby Bauer disc diffusion method as per CLSI guidelines.
Results: A total of 100 samples of ET secretions were collected and proceeded for culture. Out of 100 samples, 76 (76.0%) were positive for bacterial growth. Among 76 positive cultures, a total 80
bacterial isolates were obtained as some cultures were showing polymicrobial growth. Five (6.26%) isolates were Gram Positive bacteria and 75(93.7%) were Gram negative. The most frequent isolates
were Acinetobacter baumannii 35(43.7%) followed by Klebsiella pneumoniae 25(31.2%) Pseudomonas aeruginosa 7(8.75%), Acinetbacter baumannii isolates were sensitive to colistin while resistant to ampicillin and amoxiclav. Klesiella pneumoniae isolates were sensitive to colistin and resistant to ampicillin, amoxiclav, ciprofloxacin, cefixime, piperacillin tazobactam. Pseudomonas aeruginosa isolates were
sensitive to colistin while resistant to ampicillin, amoxiclav, ceftizidime and piperacillin tazobactam.
Conclusion: In our study antimicrobial pattern of isolated bacteria shows multidrug resistant pathogens which are associated with VAP and limit therapeutic options.
Keyword :
Acenetobacterbaumanii, Antimicrobial resistance, Health care infections, Ventilator Associated Pneumonia (VAP).