Profile and antibiotic-resistance pattern of bacteria isolated from endotracheal secretions of mechanically ventilated patients at a tertiary care hospital

Mohan Bilikallahalli Sannathimmappa; Vinod Nambiar; Rajeev Aravindakshan; Nashwa M Al-Kasaby

doi:10.4103/jehp.jehp_1517_20

Profile and antibiotic-resistance pattern of bacteria isolated from endotracheal secretions of mechanically ventilated patients at a tertiary care hospital

J Educ Health Promot. 2021 May 31;10(1):195. doi: 10.4103/jehp.jehp_1517_20. eCollection 2021.

Authors

Mohan Bilikallahalli Sannathimmappa¹, Vinod Nambiar¹, Rajeev Aravindakshan², Nashwa M Al-Kasaby^{3

4}

Affiliations

¹ Department of Microbiology and Immunology, College of Medicine and Health Sciences, National University of Science and Technology, Oman.
² Department of Community Medicine, All India Institute of Medical Sciences, Andhra Pradesh, India.
³ Department of Pathology, Sohar Hospital, Ministry of Health, Oman.
⁴ Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Abstract

Background: Critically ill patients on mechanical-ventilation are always at a higher risk of acquiring ventilator-associated respiratory infections. The current study was intended to determine the antibiotic-resistance pattern of bacteria recovered from the endotracheal (ET) specimens of ventilated patients.

Materials and methods: This was a single-centered, retrospective study carried out in a 400-bed tertiary care hospital in Oman. The data of profile and antibiotic resistance pattern of bacterial isolates recovered from ET aspirates of ventilated patients during the period from January 2017 to August 2019 were retrieved from hospital database. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) software version 22 (IBM, Armonk, New York, USA). Descriptive statistics were applied to find the frequencies and percentages. Charts and tables were constructed.

Results: In total, 201 bacterial isolates recovered from ET secretions of 154 ventilated patients were studied. The rate of isolation was predominant among males (65.6%) and in elderly people (50%). Gram-negative bacilli (GNB) were predominantly (88.6%) isolated. Acinetobacter baumannii (31.3%) was the most common isolate and 86% of them were multidrug-resistant strains. Klebsiella pneumoniae (23.9%) and Pseudomonas aeruginosa (22.9%) were the other common GNB, whereas Staphylococcus aureus was the most frequently isolated Gram-positive bacteria. Gentamicin showed good in vitro activity against S. aureus and all the GNB except A. baumannii reflecting good choice for empirical therapy.

Conclusion: Gram-negative bacteria were the predominant isolates in ET secretions of ventilated patients. There was an alarmingly high rate of antimicrobial resistance among GNB. A rational use of antibiotics, regular monitoring of antibiotic resistance and use of right combination of drugs, in addition to refining of existing infection control practices are critical to control the emergence of drug-resistant strains.

Keywords: Acinetobacter; critical care; drug resistance; mechanical ventilation; respiratory infections.