scholarly journals Bacteriological profile and their antibiogram from Endotracheal aspirate and Bronchoalveolar lavage fluid samples from intensive care unit patients

Author(s):  
Vasundhara Sharma ◽  
Pallavi Chitrans ◽  
Mazher Maqusood ◽  
Umar Farooq ◽  
Sudhir Singh ◽  
...  

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. Bacteriological profile and their antibiogram from endotracheal aspirate and bronchoalveolar lavage fluid samples from intensive care unit patients.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. 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.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.

2021 ◽  
Vol 05 (01) ◽  
pp. 012-017
Author(s):  
Sarvesh Pal Singh ◽  
Seshagiribabu Yagani ◽  
Shamsiya TP ◽  
Shivam Pandey ◽  
Manoj Kumar Sahu ◽  
...  

Abstract Background Based on the analysis of infections and antibiotic usage in the years 2013 and 2014, an evidence-based antibiotic protocol was developed and implemented in our cardiac surgical intensive care unit (CSICU). This study intends to study the impact of this new protocol on the sensitivity profiles of common gram-negative bacteria in our CSICU. Methods The medical records of patients who underwent cardiac surgery at our center, between January 2017 and December 2018, were reviewed and the incidence of different hospital-acquired bacteria and their antibiotic sensitivity profiles were recorded. The antibiotic-sensitivity profiles of common gram-negative bacteria, for the years 2017 and 2018, were compared with the published data of 2013 and 2014 from our department. Results There was a significant decrease in the incidence of Acinetobacter baumannii, Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa resistant to carbapenems during 2017 and 2018. The incidence of colistin-resistant A. baumannii and P. aeruginosa also decreased significantly in 2017 and 2018. A significant increase in the proportion of amikacin resistant A. baumannii and E. coli and A. baumannii resistant to B lactam/B lactamase inhibitors also occurred. Conclusion Antibiotic stewardship can reverse the antibiotic resistance of common gram-negative bacteria in the ICU.


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