Publication:

Organisms isolated from endotracheal aspirate and their sensitivity pattern in patients suspected of ventilator associated pneumonia in a tertiary care hospital

Background Ventilator associated pneumonia in critically ill patients are associated with high morbidity and mortality. Patients who are mechanically ventilated are at high risk of acquiring respiratory infections due to complex interplay between the endotracheal tube, host immunity and virulence of invading bacteria. To start empiric antimicrobial therapy knowledge of local antimicrobial resistance patterns are essential. Objectives of our study was to study antimicrobial sensitivity among organisms isolated from endotracheal aspirates of patients with VAP.

Methods This is a prospective observational study, done in 100 patients who were mechanically ventilated for various reasons in ICU of our hospital over a period of one year. Clinical parameters, investigation, microbiological profile and sensitive characteristics of endotracheal aspirate was recorded and analyzed.

Results Endotracheal aspirate culture and sensitivity was done in 100 patients.70 samples showed significant growth. Acinetobacter were isolated in 30 samples, Pseudomonas in 24, Klebsiella in 8, Enterobacter in 1, Citrobacter in 1 and Staphylococcus in 6 samples. Acinetobacter, Pseudomonas and Klebsiella were highly sensitive to colistin and polymyxin B, intermittently sensitive to meropenem and showed resistance to most of commonly used antibiotics.

Conclusions The commonest organism isolated endo-tracheal aspirate cultures were Acinetobacter and Pseudomonas which was highly sensitive to colistin and polymyxin B. A local antibiogram for each hospital, based on bacteriological patterns and susceptibilities is essential not only to initiate empiric therapy but also to prevent poor outcomes and help in framing the appropriate institutional antibiotic policy.