A Study of Bacteriological Profile of Pleural Fluid and Antibiogram of Isolates at Pandit Dindayal Upadhyay Medical College Andhospital College, Rajkot

Abstract

Background: The bacteriology of thoracic empyema has been changing since the introduction of antibiotics. Gram stain and culture has for decades been the “gold standard” for the detection of microorganisms in pleural fluid samples. The present retrospective study was designed to review our experience with the microbial causes of empyema and their antibiotic sensitive patterns. The knowledge of likely prevalent strains along with their antimicrobial sensitive pattern helps in the framing of antibiotic policy and better management of patients.
 Materials and Methods: This descriptive study was including 500 cases suspected of bacteriological infection of pleural fluid in patients admitted in ward of PDU Government Hospital, Rajkot. The performa include serial number, register number, age, sex, ward, clinical features of patients and investigation. All the samples were inoculated into Blood agar and MacConkey agar and Nutrient agar. All the plates were incubated aerobically at 370 C and results were read after 24 hours. If no growth present it is further incubated for next 24 hours. One smear was prepared on clean glass slide, then air dried and was heat fixed. Gram staining was done by standard technique.
 Results: This study include 500 cases of pleural effusion from January 2015 to July 2016, out of which 87 cases show positive Bacterial culture growth and 232 cases were adenosine deaminase positive. In total 87 positive bacterial cultures, 20(22%) show bacterial pathogens in gram stain. Total positive culture found in 17.4%. Among them; most common Bacteria isolated was Pseudomonas aeruginosa in 40 (45%) patients, this was followed by Klebsiella pneumonaie in 21 (24%), Staphylococcus aureus in 10 (11.49%), Acinetobacter spp. in 4 (4.59%), Proteus spp.in 3 (3.44%) and Providencia in 1 (1.14%).
 Conclusion: Pleural space infection continues to be prevalent in our country particularly in the lower socioeconomic strata due to the delay in seeking medical care, inappropriate antibiotics and dosages and duration of antibiotic treatment. All gram positive bacteria isolate were 100% sensitivity to Rifampicin, Vancomycin, Linezolid.