Bacterial Isolates from Tracheal Aspirates and their Anti-microbial Susceptibility in Mechanically-Ventilated Children with Pneumonia Admitted to an Urban Critical Care Ward

Abstract

Background and Aims: Data on Bacterial isolates from tracheal aspirates in children with severe pneumonia requiring intubation and mechanical ventilation especially in developing countries are very limited. We examined the microbial spectrum of bacteria isolated from tracheal aspirate of those children. The antibiotic susceptibility profiles of those bacteria were also examined.Methods: We evaluated the data of all mechanically ventilated children aged 0-59 months admitted to Intensive Care Unit (ICU) of “Dhaka Hospital” of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) between August 2009 and July 2013 having their tracheal aspirate culture done. Data were extracted from electronic medical records of the Dhaka Hospital.Results: Among 836 admitted pneumonia children in the ICU, we identified 35 children who fulfilled the inclusion criteria. Among them 34 (97%) had positive bacterial growths: Klebseilla species in 14 (40%), Escherichia coli in 11 (31%), Acinetobacter in 8 (23%) and Streptococcus species in 8 (23%). Additionally, Enterococcus, Staphylococcus aureus, Pseudominas and Proteus species were identified in 6 (17%), 4 (11%), and 2 (6%) of the children respectively. The susceptibility of the gram-negatives, except Klebseilla, to ampicillin, cotrimoxazole, gentamycin, ciprofloxacin, azithromycin, and ceftriaxone ranged from 0- 54%, while that for ceftazidime and amikacin ranged from 12-80%. The sensitivity of Klebseilla to these antibiotics ranged from 0-100%.Conclusions: Our data suggests that gram-negative bacteria, Klebseilla followed by Escherichia coli, and Acenetobacter are the predominant bacteria associated with severe pneumonia in ventilated children. The increased number of infections caused by Gram-negative bacteria is being accompanied by rising rates of multi-drug resistance which underscores the importance of aggressive antimicrobial therapy in the management of such children.Bangladesh Crit Care J September 2014; 2 (2): 60-64

Bacteriological profile of Tracheal aspirate and their Antimicrobial Sensitivity Pattern in a Tertiary Care Hospital in Dhaka city

“…05(07.14%) & Staphylococcus aureus 03(04.28%) (Table 3). Similar findings were reported in a study done in Bangladesh by Shahunja et al the most common isolates were Klebsiella 45% followed by Acinetobacter 36% and Pseudomonas 14% 20 . Different studies have been performed to assess the bacterial profile and antibiotic susceptibility pattern in tracheal aspirate samples.…”

The Antibiogram of Isolated Pathogens from Tracheal Aspirate among Intubated Patients 2 Months – 5 Years Old with very Severe Community-Acquired Pneumonia Admitted in Pediatric Intensive Care Unit of a Tertiary Hospital in Cebu City from 2013-2016

“…18 The use of prior antibiotic treatment was recognized as the only risk factor associated with CAP caused by multidrug resistant P. aeruginosa. 20 The resistance level of P. aeruginosa to imipenem is 35.2% but lower in meropenem (5.8%) in this study. Ceftazidime which has a good anti-Pseudomonal activity has a low resistance rate at 5.8% which was much lower compared to the result done in Dongguan, China wherein the resistance of Pseudomonas aeruginosa to ceftazidime was 13.61 and 30.99% in a separate study done in children 1-10 years old with lower respiratory tract infection in Nepal.…”

Outcome of microbiologically proven pneumonia by nasopharyngeal aspirate of infant attending in a tertiary care hospital

“…12 In the present study, we identified etiological agent by the conventional culture studies of NPA in 47.3% cases, predominance of gram negatives in this population (figure1). Taneja, et al 13 and Shahunja et al 14 …”