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Antibiotic sensitivity pattern of gram negative bacilli isolated from the lower respiratory tract of ventilated patients in the intensive care unit

Author(s): Goel Nidhi | Chaudhary Uma | Aggarwal Ritu | Bala Kiran

Journal: Indian Journal of Critical Care Medicine
ISSN 0972-5229

Volume: 13;
Issue: 3;
Start page: 148;
Date: 2009;
Original page

Keywords: Antibiotic susceptibility | gram negative bacilli | intensive care unit | ventilated patients

Background: Lower respiratory tract infections (LRTIs) are the most frequent infections among patients in Intensive care units (ICUs). Aims: To know the bacterial profile and determine the antibiotic susceptibility pattern of the lower respiratory tract isolates from patients admitted to the ICU. Settings and Design: Tertiary care hospital, retrospective study. Materials and Methods: Transtracheal or bronchial aspirates from 207 patients admitted to the ICU were cultured, identified, and antibiotic sensitivity was performed by standard methods. Statistical Analysis Used: SPSS software was used for calculation of % R of 95% confidence interval (CI). Results: Of 207 specimens, 144 (69.5%) were culture positive and 63 (30.4%) showed no growth. From 144 culture positives, 161 isolates were recovered, of which 154 (95.6%) were Gram negative bacilli (GNB). In 17 (11.0%) patients, two isolates per specimen were recovered. The most common GNB in order of frequency were Pseudomonas aeruginosa (35%), Acinetobacter baumannii (23.6%), and Klebsiella pneumoniae (13.6%). A very high rate of resistance (80-100%) was observed among predominant GNB to ciprofloxacin, ceftazidime, co-trimoxazole, and amoxycillin/clavulanic acid combination. Least resistance was noted to meropenem and doxycycline. Conclusion: Nonfermenters are the most common etiological agents of LRTIs in ICU. There is an alarmingly high rate of resistance to cephalosporin and β-lactam-β-lactamase inhibitor group of drugs. Meropenem was found to be the most sensitive drug against all GNB. Acinetobacter and Klebsiella spp. showed good sensitivity to doxycycline.
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