Microbiological profile and anti-microbial susceptibility pattern of isolates from endo tracheal aspirate and endo tracheal tube tips in ICU patients: A comparative study

Amruta Kar; Swetalona Pattanaik; Sarita Kumari Nayak; Deepak Kumar; Nishath Sayed Abdul; Mahesh Shenoy; G C Shivakumar

doi:10.53730/ijhs.v6nS8.11566

Authors

Amruta Kar Associate Professor. Department of Microbiology, Hitech Medical College and Hospital, Bhubaneswar, Odisha, India
Swetalona Pattanaik Associate Professor. Department of Microbiology, Hitech Medical College and Hospital, Bhubaneswar, Odisha, India
Sarita Kumari Nayak Assistant Professor, Department of Microbiology, Hitech Medical College and Hospital, Bhubaneswar, Odisha, India
Deepak Kumar Assistant Professor, Department of Microbiology, Hitech Medical College and Hospital, Bhubaneswar, Odisha, India
Nishath Sayed Abdul Faculty of Oral Pathology, Department of OMFS and Diagnostic Sciences, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
Mahesh Shenoy Faculty of Oral Pathology, Department of OMFS and Diagnostic Sciences, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
Shivakumar G C Professor, Department of Oral Medicine & Radiology, People’s College of Dental Sciences and Research Centre, People’s University, Bhopal, India

Keywords:

antibiotics, endo tracheal aspirates, ETT tips, gram staining, ICU, microbial invasion

Abstract

Background: There has been a surge of sufferers contracting healthcare-acquired infections (HAIs) in recent times. This has been further exacerbated by the SARS-CoV-2 pandemic which, beginning in 2020, has severely affected the majority of the world's nations, and one of the biggest problems caused by this infection was the high number of patients who required critical care. Aim: We sought to identify the microbiological profile and antimicrobial susceptibility pattern of bacteria isolated from tracheal aspirate and endotracheal tube (ETT) tips of patients who had to undergo ICU admittance. Methodology: We isolated a total of 150 microbial samples from 131 patients, of which 97 came from endo tracheal aspirates and the remaining 53 samples were obtained from ETT tips, following which the isolation and identification of bacteria was then done according to requisite microbiological assays. The Kirby-Bauer Technique with Mueller-Hinton agar was used to conduct the antimicrobial susceptibility testing in accordance with Clinical and Laboratory Standards Institute (CLSI) 2016 standards. Results: 53 (35%) of the 150 total specimens were from ETT tips, whereas 97 (65%) came from tracheal aspirates. 101 (67%) of the organisms were gram-negative, and 49 (33%) were gram-positive.

Downloads

Download data is not yet available.

References

Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, van der Poll T, Vincent JL, Angus DC The third international consensus definitions for sepsis and septic shock (Sepsis-3). (2016), JAMA 315(8):801–810.

Reinhart K, Daniels R, Kissoon N, Machado FR, Schachter RD, Finfer S recognizing sepsis as a global health priority—a WHO resolution. N Engl J Med (2017), 377(5):414–417.

Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, Colombara DV, Ikuta KS, Kissoon N, Finfer S, Fleischmann-Struzek C, Machado FR, Reinhart KK, Rowan K, Seymour CW, Watson RS, West TE, Marinho F, Hay SI, Lozano R, Lopez AD, Angus DC, Murray CJL, Naghavi M Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. The Lancet (2020) 395(10219):200–211.

Fleischmann C, Scherag A, Adhikari NK, Hartog CS, Tsaganos T, Schlattmann P, Angus DC, Reinhart K Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations. Am J Respir Crit Care Med (2016), 193(3):259–272.

Sakr Y, Jaschinski U, Wittebole X, Szakmany T, Lipman J, Namendys-Silva SA, Martin-Loeches I, Leone M, Lupu MN, Vincent JL Sepsis in intensive care unit patients: worldwide data from the intensive care over nations audit. Open Forum Infect Dis (2018) 5(12):313.

Rhee C, Dantes R, Epstein L, Murphy DJ, Seymour CW, Iwashyna TJ, Kadri SS, Angus DC, Danner RL, Fiore AE, Jernigan JA, Martin GS, Septimus E, Warren DK, Karcz A, Chan C, Menchaca JT, Wang R, Gruber S, Klompas M Incidence and trends of sepsis in US hospitals using clinical vs claims data, (2017) JAMA 318(13):1241–1249.

Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon N. The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respir Med (2018) 6(3):223–230.

Saito H, Kilpatrick C, Pittet D. The 2018 World Health Organization SAVE LIVES: clean your hands campaign targets sepsis in health care. Intensive Care Med (2018) 44(4):499–501.

World Health Organization “Report on the burden of endemic health care-associated infection worldwide”- World Health Organization, Geneva (2011) https://apps.who.int/iris/bitstream/handle/10665/80135/9789241501507_eng.pdf

Suetens C, Latour K, Karki T, Ricchizzi E, Kinross P, Moro ML, Jans B, Hopkins S, Hansen S, Lyytikainen O, Reilly J, Deptula A, Zingg W, Plachouras D, Monnet DL. Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, (2018) https://doi.org/10.2807/1560-7917.es.2018.23.46.1800516

Magill SS, O’Leary E, Janelle SJ, Thompson DL, Dumyati G, Nadle J, Wilson LE, Kainer MA, Lynfield R, Greissman S, Ray SM, Beldavs Z, Gross C, Bamberg W, Sievers M, Concannon C, Buhr N, Warnke L, Maloney M, Ocampo V, Brooks J, Oyewumi T, Sharmin S, Richards K, Rainbow J, Samper M, Hancock EB, Leaptrot D, Scalise E, Badrun F, Phelps R, Edwards JR. Changes in prevalence of health care-associated infections in U.S. Hospitals. N Engl J Med (2018) 379(18):1732–1744.

Shalini S, Kranthi K, Gopalkrishna Bhat K. The microbiological profile of nosocomial infections in the intensive care unit. J Clin Diagnostic Res (2010) 4:3109–012

Ali II, Khan IA, Munir MK. Frequency of multi-drug resistant nosocomial pathogens in intensive care units of a tertiary care hospital in Karachi. Ann King Edward Med Univ 2017; 23:1–7

Chaudhry D, Prajapat B. Intensive care unit bugs in India: how do they differ from the western world? J Assoc Chest Physicians. (2017) 5:10.

Hafeez A, Munir T, Najeeb S, Rehman S, Gilani M, Ansari M, et al. ICU pathogens: a continuous challenge. J Coll Physicians Surg Pak (2016) 26:577–80.

Reddy PS, Athuluri V, Kumar SS. Incidence of ventilator associated pneumonia. J Microbiol Biotechnol Res (2013) 3:1–4.

Gupta R, Malik A, Rizvi M, Ahmed M, Singh A. Epidemiology of multidrug-resistant Gram-negative pathogens isolated from ventilator-associated pneumonia in ICU patients. J Glob Antimicrob Res (2017) 9:47–50.

Shehata I, Shabban M, Ibrahim R, Shoukry Y. Endotracheal tube biofilm and its relationship to ventilator associated pneumonia in a neonatal ICU. Nat Sci (2012) 10:133–40.

J Young P, J Doyle A. Preventing ventilator-associated pneumonia-the role of the endotracheal tube. Curr Respir Med Rev (2012) 8:170–83.

Ravi K, Maithili T, Thomas DM, Pai SP. Bacteriological profile and outcome of ventilator associated pneumonia in intensive care unit of a tertiary care centre. Asian J Med Sci (2017) 8:75–9.

Pneumatikos IA, Dragoumanis CK, Bouros DE. Ventilator associated pneumonia or endotracheal tube-associated pneumonia? An approach to the pathogenesis and preventive strategies emphasizing the importance of endotracheal tube. Anesthesiology: J Am Soc Anesth (2009) 110:673–80.

Goel N, Chaudhary U, Aggarwal R, Bala K. Antibiotic sensitivity pattern of gram-negative bacilli isolated from the lower respiratory tract of ventilated patients in the intensive care unit. Indian J Crit Care Med (2009) 13:148

Ejaz A, Tarar M, Naeem T, Naeem M, Ijaz S, Qureshi M. Frequency of multidrug resistant and extensively drug resistant organisms in tracheal aspirates–experience at a tertiary care hospital. Biomedica (2016) 32:77.

Hejazi ME, Nazemiyeh M, Seifar F, Beheshti F. Polymicrobial ventilator associated pneumonia and antibiotic susceptibility of bacterial isolates in a university hospital, Tabriz, Iran. Afr J Bacteriol Res (2015) 7:52–5.

Jampala BL, Toleti S, Kolipaka SR, Myneni RB. A clinicomicrobiological study in patients undergoing mechanical ventilation in a tertiary care hospital. Int J Res Med Sci (2016) 4:2856–8

Chandra D, Laghawe A, Sadawarte K, Prabhu T. Microbiological profile and antimicrobial sensitivity pattern of endotracheal tube aspirates of patients in ICU of a tertiary care hospital in Bhopal, India. Int J Curr Microbiol App Sci (2017) 6:891 5

Kidwai AA, Razzaq S, Jamal Q, Aatif S, Paracha S. Antibiotic resistance among gram negative bacilli causing ventilator–associated pneumonia. Pak J Chest Med (2011) 17

Panda G, Mohapatra BP, Routray SS, Das RK, Pradhan BK. Organisms isolated from endotracheal aspirate and their sensitivity pattern in patients suspected of ventilator-associated pneumonia in a tertiary care hospital. Int J Res Med Sci (2018) 6:284–8

Ranjan N, Ranjan K, Chaudhary U, Chaudhry D. Antimicrobial resistance in bacteria causing ventilatorassociated pneumonia in a tertiary care hospital: one-year prospective study. Int J Res Med Sci (2014) 2:228–33.

Juayang AC, Maestral DG, de los Reyes GB, Acosido MA, Gallega CT. Review on the antimicrobial resistance of pathogens from tracheal and endotracheal aspirates of patients with clinical manifestations of pneumonia in Bacolod City in 2013. Int J Bacteriol (2015)

Joseph NM, Sistla S, Dutta TK, Badhe AS, Rasitha D, Parija SC. Ventilator-associated pneumonia in a tertiary care hospital in India: role of multi-drug resistant pathogens. J Infect Dev Ctries (2010) 4:218–25.

Bahrami H, Rahbar M, Rahimifard N, Mehdipour HH, Rastegar H, Ashtiani HA, et al. Etiology and drug resistance pattern of ventilator associated pneumonia in an Iranian 1000-bed tertiary care hospital. Br Microbiol Res J (2014) 4:1211.

Wahyuni, S., Chalid, S. M. T., Pelupessy, N. U., Arifuddin, S., Idris, I., & Usman, A. N. (2022). Comparison of the use of shock index and modified early obstetric warning score in COVID-19 obstetric emergency patients as ICU care parameters. International Journal of Health & Medical Sciences, 5(1), 80-90. https://doi.org/10.21744/ijhms.v5n1.1844

Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2021). Health and treatment of diabetes mellitus. International Journal of Health Sciences, 5(1), i-v. https://doi.org/10.53730/ijhs.v5n1.2864