Abstract :
Background: Bacterial respiratory infections are most commonly causes of illness for all age group patients in ICU. Most of the patients suffer from urosepsis, postoperative disease and lower respiratory infection when admitted in ICU’s. The main purpose of this study is control in ICU’s infection & determine their antibiotic sensitivity pattern for better treatment of patients.
Aim & Objective: Bacteriological profile and their antibiogram from endotracheal aspirate and bronchoalveolar lavage fluid samples from intensive care unit patients.
Materials and Methods: We performed manual culture of Endotracheal aspirate & BAL fluid specimens collected from ICU’s patients. Samples were cultured on Blood agar and Mac-Conkey agar then incubated at 37C for 24 hours. Any growth were further confirmed by Gram stain and appropriate biochemical tests, and then Antibiotic sensitivity test was done.
Result: Among the 123 mechanically ventilated patients and 68 of them developed positive samples. In this study 55.3% (68) pathogenic isolates, 4.1% (5) were non pathogenic isolates and 40.6 (50) were no growth isolates in BAL and endotracheal aspirate samples. In which 67.6% (46) male and 32.4% (22) female patients. Older population falling in the 40-50 years of age group contributes the majority (27.64%) of the infection undergoing treatment for LRT infection in ICU’s patients in TMMC & RC, Moradabad, and in 70-80 years of age group (4.06%) was less contributes of this infection. Among the causative agents, were most common among gram negatives and was common among the gram positive isolates. In our study more resistance gram positive antibiotics were CIP, E, LE, and most sensitive antibiotics were VA, LZ, GEN and TEI. And gram negative bacteria most resistant antibiotics were OF, CPM, CAZ, CIP, CTR, MRP, LE, IPM, PIT and most sensitive antibiotics were AK, GEN, CL, TGC. In this study we conclude that Gram-negative bacilli were predominant in BAL fluid and endotracheal aspirates of ICU patients. Out of 68 multidrug resistance isolates, 1.47% were MRSA, 41.17% were ESBL and 57.36% were MBL isolates higher rate of ESBL production seen in spp., and higher rate of MBL production in spp.
Conclusion: High incidence of VAP and the potential MDR pathogens are a real threat in our ICU’s. Combined approach of judicious antibiotic usage and training programs to health care personnel might be of help in combatting high incidence of antibiotic resistance in our institute.
Keyword :
ICU Intensive Care Unit, BAL Bronchoalveolar lavage, MDR Multidrug resistant