scholarly journals Microbiological Profile of Severe Lower Respiratory Tract Infection in Intensive Care Unit of a Tertiary Care Center of Dhaka, Bangladesh

2015 ◽  
Vol 2 (2) ◽  
pp. 53-56
Author(s):  
M Abdul Mannan ◽  
M Abul Kashem ◽  
Fazle Rabbi Mohammed ◽  
Raihan Rabbani ◽  
M Motiul Islam
Keyword(s):  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
High Rate ◽  
Sensitivity Pattern

Background: Microbial resistance to antibiotics is nowadays a great threat to intensive care unit patients especially in severe pneumonia leading to high morbidity and mortality. Bacterial profile and antibiotic sensitivity pattern would help clinician in selecting more proper empirical therapy before isolation of microbes.Materials and Methods: This retrospective study was performed among 210 patients of lower respiratory tract infection in intensive care unit in Square Hospitals Ltd, a tertiary care hospital in Dhaka. Sputum, tracheal aspirates or broncho alveolar lavage were cultured, identified and antibiotic sensitivity pattern performed by standard methods.Results: Of 210 specimens, 150 (71%) were culture positive and 60 (29%) showed no growth. From 150 culture positives, 216 isolates were recovered, of which 7 specimen shows more than 2 organisms each, 52 specimen shows 2 isolates per specimen remaining 91 specimen with single isolates were recovered. The most common organisms in order of frequency were, Acinetobacter baumannii (24.0%), Staphylococcus aureus (20.6%), Klebsiella pneumoniae (19.3%), Pseudomonas aeruginisa (19.3%), Escherichia coli (14%) and Candida albicans (13%). A very high rate (83-93%) of resistance was observed among Acinetobactor baumanni to Beta lactum and clavulanate, Cephalosporin, Quinolones and Carbapenem. No resistant was observed with Colistin. Linezolid and Vancomycin are most effective against methicillin resistant Staphylococcus aureus, Coagulase negative Staphylococcus aureus and Escherichia coli, where no resistance was found.Conclusion: Farmenter and nonfermenters are the both common etiological agents of lower respiratory tract infections in this intensive care unit. There is high rate of resistance to commonly used cephalosporin and ?-lactam-?-lactamase inhibitors and quinolone group of drugs. Acinetobacter baumannii, Pseudomonas aeruginisa and Klebsiella showed most sensitivity to Colistin and actually no resistance was found.Bangladesh Crit Care J September 2014; 2 (2): 53-56

scholarly journals Antimicrobial Sensitivity Pattern in the Mixed Intensive Care Unit in a Tertiary Care Hospital of Eastern Nepal

2020 ◽  
Vol 2 (2) ◽  
pp. 9-15
Author(s):  
Niraj Kumar Keyal ◽  
Mahendra Shrestha ◽  
Partima Sigdel Ghimire
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Polymyxin B ◽  
Clinical Samples ◽  
Care Hospital ◽  
Gram Negative ◽  
Sensitivity Pattern

 Background: Empirical antibiotics are used in the intensive care unit based on developing countries’ guidelines due to a lack of a bacteriological profile of individual ICU and institution policy. Therefore, this study was conducted to know the antibiogram of the intensive care unit and to make institution policy for antibiotic use in ICU. Materials and methods: It was a prospective descriptive cross-sectional study conducted in the mixed surgical and medical intensive care unit of a tertiary care hospital for one year in 625 patients. Various clinical samples were collected aseptically and organisms were identified by the cultural characteristics, morphology, gram stain, and different biochemical test. Antimicrobial susceptibility was done with a disc diffusion test. Data collection was done in a preformed sheet that included all tested antibiotic and demographic variables. Statistical analysis was done by using statistical package for the social sciences. The result was presented as frequency and percentage. Results: Out of 625 samples, 135(22%) showed growth in culture. Among them, 96(71%) and 39(29%) were gram-negative bacilli and gram-positive cocci respectively. The tracheal aspirate was the most common type of specimen which comprised 49(36.29%) isolates. The most common organism was Staphylococcus aureus which accounts for 27(20%) isolates, followed by Acinetobacter baumanni 25(18.51%), Klebsiella pneumoniae 22(16.29%) and Pseudomonas aeurignosa 21(15.55%). The incidence of multidrug-resistant and extended drug resistance was 44(32.5%) and 45(33%) respectively. Meanwhile, the incidence of methicillin-resistant staphylococcus aureus was 70%. However, in the case of Acinetobacter baumannii and Enterobacteriaceae, all were sensitive to polymyxin B and meropenem. Conclusion:Antibiotics should be prescribed based on the antibiogram of individual intensive care units that can decrease antibiotic resistance. Polymyxin B and meropenem can be prescribed for gram-negative bacilli and vancomycin for Staphylococcus aureus.

scholarly journals Infection Route Analysis of Ventilator Associated Pneumonia

2012 ◽  
Vol 1 (4) ◽  
pp. 211-215
Author(s):  
Wei Guo ◽  
Jie Zhang ◽  
Jing-yun Li ◽  
Yue Ma ◽  
Sheng-hui Cui
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Tract ◽  
Gastric Juice ◽  
Lower Respiratory Tract ◽  
Care Center ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Ventilator Associated Pneumonia ◽  
Subglottic Secretion

Abstract Objective A prospective study was conducted in a tertiary care center to identify the risk factors of ventilator associated pneumonia (VAP) through phenotypic and molecular biological methods. Methods The patients who were mechanically ventilated in the respiratory intensive care unit (RICU) and the neurological internal intensive care unit (NICU) were enrolled in our study, and samples were collected from the lower respiratory tract, oropharynx and stomach. Other samples, including the environmental air, swabs of nurses’ hands, subglottic secretion and ventilator circuit, were also collected. Microorganisms in the collected samples were recovered and identified at species level by biochemical detection. Genetic relationship of dominant species was further characterized by pulsed field gel electrophoresis (PFGE). Results Out of 48 enrolled patients, 22 cases developed VAP and bacterial cultures were recovered from the lower respiratory tract samples of 14 cases. The average hospitalization time with VAP was significantly longer than that of patients without VAP (P < 0.05). Among the recovered bacteria cultures, multidrug-resistant Pseudomonas aeruginosa and Stenotrophomonas maltophilia were dominant. It was more likely that subglottic secretion and gastric juice samples contained the same isolates as recovered in the lower respiratory tract by PFGE analysis. Conclusions Mechanical ventilation in RICU and NICU was a high risk factor for VAP development. Special emphasis of VAP prophylaxis should be paid on subglottic secretion and gastric juice reflux.

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