Bacteriological Profile and antibiogram of isolates from tracheal secretions of patients in an intensive care unit

Abstract

Hospital-acquired pneumonia (HAP) is defined as an infection in patients admitted in hospital for more than 48hours, and ventilator associated pneumonia (VAP) can be defined as infection occurring in patients admitted in ICU after 48hrs endotracheal intubation and mechanical ventilation. VAP has a mean of 7.3/1000 ventilator days for medical ICU patients and 13.2/1000 ventilator days for surgical ICU patients. The crude mortality rates for HAP are approximately 10% and are higher for VAP, ranging from 20% to 60%. The culture of endotracheal (ET) aspirates will help know the etiological agent and formulate the antibiotic policy for early treatment. To isolate the bacterial pathogens of ET secretions from patients with VAP and know their antibiotic susceptibility pattern. In the present study, out of 102 endotracheal secretions from cases of VAP, 88 samples (86.27%) were culture positive, and the remaining 14 samples (13.73%) were culture negative. Out of the 88 positive cultures, 62 samples (60.78%) showed growth of single isolates, and 26 samples (25.49%) showed multiple isolates. Out of the 114 isolates, 18 isolates (15.8%) were gram positive organisms, and 96 isolates (84.2%) were gram negative organisms. Of the gram positive isolates, the predominant organism was Methicillin resistant (MRSA) (55.56%), followed by Methicillin sensitive (MSSA) (22.22%) and (22.22%). Out of the gram negative isolates, the predominant organism was (36.46%), followed by Acinetobacter spp (25%), (23.96%), (12.5%), (1.04%), and Proteus mirabilis (1.04%). In the present study, Gram positives isolates showed the highest susceptibility to vancomycin and linezolid (100%), and gram negative isolates showed the highest susceptibility to polymyxin B (100%) and meropenem (47.92%). The study gives insight into the bacterial pathogens and their antibiotic susceptibility patterns of isolates from endotracheal secretions of mechanically ventilated patients to prevent the mortality and morbidity of mechanical ventilation and VAP, helping in formulating an antibiotic policy for appropriate empirical therapy.