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Microbiological infection plays vital role in determining the outcome as well as cost and duration of the hospital stay for patients admitted in ICU setup. Of late nosocomial infections especially ventilator associated pneumonias (VAP) have been recognized to be associated with significant morbidity and mortality in intubated patients. It is of critical importance to do regular surveillance of important pathogen (like Methicillin resistant staphylococcus aureus (MRSA), extended spectrum beta lactamase (ESBL) and carbapenemase producers) and its resistance pattern. Culture and sensitivity patterns if properly determined can greatly improve the outcome of critically ill patients being managed in intensive care units. To find out the prevalence of MRSA, ESBL and carbapenemase producing isolates in endotracheal and tracheostomy tube samples of ICU patients and to know its resistance pattern. In this study we aimed to investigate the pattern of microorganism grown and their sensitivity patterns to propose a proper antibiotic treatment in our hospital ICUs. It was a cross sectional observational study which was carried out over a period of 6 months in the department of microbiology at a tertiary care hospital. Approval of ethical committee was obtained before the study. Total 70 samples consisting of endotracheal tubes and tracheostomy tube secretions received in the department of microbiology for culture and sensitivity from patients admitted in two ICUs (SICU, MICU) were processed as per standard microbiological protocol. Pathogens were identified by vitek 2 compact system. MRSA, ESBL and carbapenemase production was detected by vitek 2 system (Biomerieux) antibioticsusceptibility testing of MRSA, ESBL and carbapenemase producers was done. Antibiotics for testing were chosen as per vitek Id cards. The sensitivity patterns of MRSA, ESBL and carbapenamase producers were analyzed. Out of 70 samples 48(68.57%) were culture positive in which 41(87.27%) were monomicrobial and 7 (12.72%) were polymicrobial (2 organisms in 7 samples). Out of 55 isolated organisms 8 were gram positive cocci (14.54%) and Gram negative organisms were 47 (85.46%). Thus total 9 types of organisms were recovered from 48 culture positive samples. Forteen Pseudomonas aeruginosa (25.54%), 14 Acinetobacter baumanni complex (25.54%), 11 Klebsiella pneumoniae. (20%) and 8 Staphylococci (including Staphylocococcus aureus 03 and 05 coagulase negative Staphylococcus (CONS) (14.54%). Followed by 3 E. coli (5.45%), 2 Enterobacter aerogens (3.64%), 1 species each of Serratia marscens, Stenotrophomonas (1.82%). Out of 8 Staphylococcus (S. aureus and CONS) isolates 5 (62.5%) were MRSA and MRCONS. Most of the MRSA isolates were recovered from the endotracheal tube. Out of all isolates of Klebsiella species and E. coli 8 species were ESBL producers (57.14%). The maximum ESBL producing isolates were recovered from MICU and were isolated from endotracheal tubes. Isolated MRSA strains were found to be susceptible to vancomycin, linezolid, teicoplanin and rifampicin...

Chronic suppurative otitis media (CSOM) is a persistent, insidious and potentially dangerous disease because of its various fatal complications. It is still a significant health problem in developing countries. It is the common cause of conductive deafness. Change in the bacteriological scenario with indiscriminate use of antimicrobial agents has been associated with the emergence of multiple drug resistant strains. Information regarding the common pathogens and their antibiotic sensitivities is essential for the proper choice of antibiotics. Hence the present study is undertaken to know the aerobic bacteriological flora of CSOM and their antibiogram. One hundred and nine clinically diagnosed cases of CSOM of all age groups and both the sexes attending ENT OPD and admitted in ENT wards were studied. Ear swab was taken from each patient, further subjected to Gram staining and culture onto blood agar, MacConkey's agar and Chocolate agar. The bacterial isolates were identified by standard biochemical reactions. Antibiotic susceptibility testing was done by Kirby-Bauer disc diffusion method. A random selection of 109 CSOM cases was studied, of which 71 were males and 38 were females. Majority of the patients were in the age group of 11 to 20 years. Predominance of Pseudomonas aeruginosa (53.91%) followed by Staphylococcus aureus (28.69%), Proteus mirabilis (6.09%), Klebsiella pneumoniae (5.23%), Citrobacter freundii (4.35%) and Escherichia coli (1.73%). Antibiotics like Imipenem, Piperacillin-tazobactum, Amikacin, ciprofloxacin and Levofloxacin were found to be more effective against all Gram positive and Gram negative isolates. Pseudomonas aeruginosa was the predominant organism followed by Staphylococcus aureus, Proteus mirabilis, Klebsiella pneumoniae, Citrobacter freundii and E. coli. The most effective drugs were Imipenem, Piperacillin-tazobactum, Amikacin, ciprofloxacin and Levofloxacin.

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