Microbiological profile of lower respiratory tract infections in neurological intensive care unit of a tertiary care center from Central India

Abstract

Background:Lower respiratory tract infections (LRTI's) are the most frequent infections among patients in intensive care units. The consequences of increased drug resistance are far reaching since bacterial infection of the lower respiratory tract (LRT) is a major cause of death from infectious disease.Objective:The study was conducted with the aim of determining the bacterial etiology of LRTI in the neuro intensive care unit (NICU) as well as to update the clinicians with the various antimicrobial alternatives available in the treatment of LRTI.Subjects and Methods:The study was conducted for the period of 3 years from January 2010 to December 2012 in the Microbiology Department of a Teaching Tertiary Care Hospital. The LRT specimens from 230 patients admitted in a NICU during the study period were processed. Following culture, the isolated organisms were identified and antimicrobial sensitivity was performed by standard methods.Results:Out of the 230 LRT specimens evaluated, 198 (86.08%) were culture positive. A total of 254 pathogens were recovered with a predominance of Gram-negative isolates (n = 243; 96.05%) Pseudomonas aeruginosa was the most dominant pathogen followed by Klebsiella pneumoniae. Alarmingly high percentage of extended spectrum beta-lactamase and methicillin resistant Staphylococcus aureus isolates were detected. The resistance to cephalosporins, aminoglycosides and carbapenem were remarkable.Conclusions:Therefore, we can conclude that for effective management of LRTI's, an ultimate and detailed bacteriological diagnosis and susceptible testing is required to overcome global problem of antibiotic resistance.

The Pattern of Bacterial Pathogens and Their Antibiotic Susceptibility Profile From Lower Respiratory Tract Specimens in a Rural Tertiary Care Centre

“…High rates of resistance to cephalosporins was noticed in several studies. (12,20) Our observation about cephalosporins match with their findings. This might be due to the extensive use of 3 rd generation cephalosporins in hospitals.…”

“…Many other studies have obtained the similar results. (4,7,17,18,19,20) The Gram-negative predominance in our study might partly be due to the unequal distribution of patients with community-acquired and hospital-acquired infections and also due to the spread of antibiotic resistance in hospital setting. The most common bacteria isolated in our study were Pseudomonas aeruginosa (32.43%), Klebsiella pneumoniae (27.03%) and Acinetobacter spp.…”

Antimicrobial susceptibility patterns of clinical isolates of Pseudomonas aeruginosa isolated from patients of respiratory tract infections in a Tertiary Care Hospital, Peshawar

“…this may be due to selective use of aminoglycosides in our setup because of their higher adverse effects. Carbapenems are widely used against gram negative and gram positive microbes; sensitivity to Meropenem was 91.55% in our study which is better than a study done in India by Bajpai et al in 201316 and in Pakistan by Fatima et al in 201217 while other studies by Chander et al in 201312 in Nepal and by Sabir et al in pakistan in 201418 showed sensitivity of Carbapenems to be 100% against Pseudomonas , this shows that resistance is developing gradually, as it is being used now in several hospitals in our locality. Highest resistance was seen to Cefoperazone + Sulbactam (83.10%) in our study as opposed to Abbas et al in 20159 and Nadeem et al In 2009 19.…”

A Study on the Microbiological Profile of Respiratory Tract Infection (RTI) in Patients Attending Gauhati Medical College & Hospital

“…Likewise, our study showed Gram negative isolates have maximum resistance to Ceftazidime, Piperacillin and Piperacillin tazobactum in contrast to study conducted by Ahemad M S et al [12] which showed high susceptibility to piperacillin-tazobactum. But present study is in concordance with results found by Nidhi Goel et al [4] In our study Amoxyclav, Amikacin and Levofloxacin had shown greater activity against Klebsiella pneumoniae similar to a study conducted by Bajpai et al [13] and in contrast to Ahmed et al study. [12]…”