A STUDY TO DETERMINE THE INCIDENCE OF BACTERIAL AND FUNGAL INFECTIONS IN ICU PATIENTS ON MECHANICAL VENTILATION AND ASSOCIATED OUTCOME

Abstract

Background: Infection in intensive care unit (ICU) patients, occurring predominantly in patients whose lungs are ventilated, at a rate of 1% to 3% per day of mechanical ventilation. Bacterial and fungal pathogens from clinical cultures were evaluated to characterize community- and ICU infections, including describing temporal changes in predominant organisms on presentation and throughout hospitalization. Aims & objective: To determine the incidence of bacterial and fungal infections in ICU patients on mechanical ventilation. Methods & materials: The study was Prospective observational case study was conducted at Medicine department in SRN Hospital, Prayagraj, U.P. India between July 2020 to June 2021. Endotracheal aspirates were collected aseptically from 100 ICU patients The various patient data such as age, gender, address, date of admission ,level of consciousness, risk factors involved, underlying diseases, duration of mechanical ventilation, prior antibiotic therapy etc. were recorded. Result: In this study total 100 out of 81 patients show micro-organism infection, 76 patients had bacterial infections and 5 had fungal infections and 19 patients had no growth, as conrmed by endotracheal tube aspirate (ETA) culture growth. Participants in the Bacterial group ETA Gram Staining was 38.2% had no abnormality detected (NAD), 52.6% had Gram Negative Bacilli and 9.2% of the participants had Gram Positive Bacilli, 100.0% of the participants in the Fungal group ETA Gram Staining had NAD. There was a signicant difference between the various groups in terms of distribution of ETA Gram Staining (χ2 = 7.366, p = 0.028). In the Bacterial endotracheal tube (ET) aspirate culture 35.5% of the participants had Klebsiella, 25.0% had Staphylococcus, 18.4% had E. coli, 18.4% had Pseudomonas, 0.0% had Candida spp, 1.3% had Acinetobacter, 1.3% had Proteus. In the Fungal ET aspirate culture group 100.0% of the participants had Candida spp. There was a signicant difference between the various groups in terms of distribution of ET aspirate: Culture (χ2 = 81.000, p = <0.001 Conclusion: Gram Negative Bacilli was the most common infection in patients on mechanical ventilation in gram staining. Klebsiella was the most common bacterial infection and Candida species was fungal infection. The poorest outcome occurred in patients with, E. coli, and Proteus group infection and good outcome occurred in Acinetobacter.