Background: Many reports have appeared in the literature of an alarming increase in hospital infections, many of which are antibiotic resistant and presumably acquired after a patient's admission to the hospital. This is a serious indictment of present-day indiscriminate antibiotic therapy of our hospitals.Endotracheal intubation is a life-saving procedure, but it is associated with a high risk of acquiring respiratory infections.1 Several factors like new mutations, selection of resistant strains and suboptimal infection control along with the use high level antibiotics influences the rapid spread of extensively drug resistant bugs in these intubated patients.. These infections are associated with significant rise in morbidity, mortality and health care cost.2,3 It is very essential for the clinicians to be aware of local bacteriological flora and their susceptibility pattern to encourage rational use of antibiotics.
Aim: 1.To identify the microbiological profile of endotracheal tube aspirates received from ICU patients. 2. To study the antimicrobial sensitivity pattern of pathogenic isolates
Materials and Methods: This was a descriptive cross sectional analytic study of endotracheal tube aspirates of patients on mechanical ventilation done from January 2019 - May 2020 and sample size was calculated based on the N - master sample size software system. All the cases were randomly selected for the study. Endotracheal tube secretions are obtained from patients in ICU by using a suction tube. The collected samples were subjected to Gram s stain and culture by standard protocols. The pathogenic isolates were identified by standard biochemical reactions and subjected to antimicrobial susceptibility testing by Kirby Bauer disc diffusion method as per standard CLSI guidelines. Data entry was done in MS Excel.
Results: Out of 150 samples 145(96.7%) were culture positive.5 samples showed no growth. Klebsiella spp was the most common organism(32.0%) . Pseudomonas aeruginosa was the next most common organism (28.0%), In Enterobacteriaceae family E. coli (13.3%) Enterobacter (2.7) Citrobacter spp.(2.0%) Protues spp. (2.0), were the most commonly detected isolates. Amongst gram positive bacteria Staphylococcus aureus (12.7%) was commonly detected. Most isolates of Pseudomonas were multi drug resistant and showed sensitivity to Gentamicin and Ciprofloxacin. The Gram Negative bacilli were mostly sensitive to Amikacin and Piperacillin Tazobactam. The Gram Positive cocci were mostly sensitive to Linezolid and Gentamicin.
Conclusion: We conclude that Ventilator Associated Pneumonia in intubated patients is on the rise and has been continually associated within discriminate and irrational use of antibiotics which contribute to emergence of drug resistant strains. Knowledge of their causative microbial flora in a local setting along with information on the susceptibility patterns will help in selection of the appropriate antibiotic for therapeutic use and a better outcome.
