Isolation and Antimicrobial Susceptibility Profile of Microorganisms Isolated from Ventilator Associated Pneumonia Patients

Abstract

Objectives: Ventilator-associated pneumonia (VAP) is the second most prevalent nosocomial infectivity in ICU and most frequent among mechanically ventilated patients. VAP is divided in the two groups based upon mechanical ventilation duration, early and late onset VAP. The most common pathogens in Pakistan were Acinetobacter lwoffi (22%), Staphylococcus aureus (33%) and Pseudomonas aeruginosa (63%). Improper antibiotic therapy has increased the frequency of MDR strains of the pathogens, further aggravating threat posed by disease. The objectives of the study were to identify the organisms up to species level and to determine the Minimum Inhibitory Concentration (MIC) of the isolated organisms by using VITEK.Methods: It was a descriptive study in which 74 patients having ventilator associated pneumonia i.e., patients who developed pneumonia after 48 hours of stay in intensive care unit of hospital were included. Collected Tracheobronchial secretions were sent to the pathology laboratory as soon as for culture and sensitivity. After initial identification of isolates, final identification/ confirmation was done by Vitek 2-compact system.Results: Among 74 patients, 51.0% were males and 54.0% were 51-60 years old. Major cause of ICU admission was head trauma and stroke. Among 72 patients, klebsiella pneumonia was identified in 37.0% patients, pseudomonas aeruginosa in 28.0% patients, acinetobacter baumannii in 21.0% patients and Escherichia coli was identified in 14.0% patients. Klebsiella pneumoniae was 100% resistant to piperacillin. Pseudomonas aeruginosa were 80% resistant to Ampicillin/salbactem. Acinetobacter baumanii was 100% resistant to ampicillin/salbactem, piperacillin, cefuroxime axetil, cefixime, ceftriaxone cefepime, aztreonam, meropenem, levofloxacin, moxifloxacin, trimethoprim. Similarly, E. coli was 60.0% resistant to ampicillin/ salbactem, piperacillin, cefuroxime, cefuroxime axetil, cefixime, ceftriaxone, cefepime, aztreonam, meropenem, levofloxacin, moxifloxacin and chloramphenicol. Conclusion:A very high prevalence of multi drug resistance organisms are noted among ventilator associated pneumonia at a teaching hospital in Pakistan.

Antimicrobial Susceptibility Profiles and Prevalence of ESBLS among Escherichia coli Isolates Recovered from Clinical Specimens in Different Services

“…Some researchers have reported resistance rate CFM from 94% to 40% to E. coli in clinical samples (Sah et al, 2016;Tasleem et al, 2018). Our results were like Cheema et al,2018 MBSJHS; 5(3), 2019 who also reported that CFM resistance rate of E. coli 61%.…”

“…The result of resistance CXM rate, E. coli isolates showed high antibiotic resistance with 60,41% CXM. Previous researchers have reported resistance rate CXM from 100% to 60% to E. coli in clinical samples (Ugwu et al, 2017;Cheema et al, 2018).…”

A prospective study on clinical profile, severity, microbiology, and outcome of patients with ventilator associated infective complications admitted in intensive care unit of a tertiary care hospital

“…For aminoglycoside and Tigecyclines 4 isolates were sensitive for each antibiotic, only two were sensitive to carbapenems. Cheema et al 32 have shown that klebsiella pneumoniae was 100% resistant to Piperacillin tazobactam. Acinetobacter was 100% carbapenem resistant, in our study also carbapenem resistance was very high among these two organisms.…”