Colonization and Antimicrobial resistance patterns of Potentially Pathogenic Micro-Organisms in tracheostomized patients

Abstract

Introduction: Tracheostomy is one of the most common and ancient surgical procedure performed in the world but it is like a double-edged sword which not only facilitates respiration, but also impairs the natural resistant barrier, therebyaugmenting the colonization of other secondary pathogenic micro-organisms. Hence, it is important to know the patternof microbiological colonizers in tracheostomized patients, so that adequate empiric antimicrobial coverage can preventdevelopment of hospital acquired pneumonia. This study aims to identify various micro-organisms colonizing lower airway in tracheostomized patients.
 Materials and Methods: An observational cross-sectional study was conducted in a tertiary based teaching hospital in North Bengal, India during July 2021 to July 2022. A total of 56 patients were included in the study.
 Results: Positive Cultures on day 0 were found in 20.8% & 65.6% of patients in wards and ICUs respectively. Out of the positive cultures isolated on day 0, Staphylococcus aureus was the most common organism (80%) obtained from ward patients whereas, Acinetobacter baumannii was most common organism (47.61%) in ICU admitted patients. On day 7, positive cultures were found in 66.6% & 84.4% of admitted patients in wards and ICUs respectively. Staphylococcus aureus was again the most common organism obtained (56.25%) in wards whereas, Pseudomonas aeruginosa was the most common organism (44.44%) obtained in ICU admitted patients followed by Acinetobacter baumannii (33.33%).
 Conclusion: Culture positivity rates were higher in patients who were previously intubated in Intensive care unit, which establishes the fact that any procedure which warrants airway manipulations, increases the chance of hospital acquired infections. Antibiotic resistance is very common in ICU admitted patients and has a tendency to increase over time. Hence, upscaling of antibiotics is recommended only after proper sensitivity check of the tracheal aspirates.