ANTIBACTERIAL SENSITIVITY OF BACTERIAL FLORA OF LOWER RESPIRATORY TRACT AFTER A WEEK OF TRACHEOSTOMY

PANDURANGA M KAMATH; VIJENDRA SHENOY S; ASWIN MUKUNDAN; SUJA SHREEDHARAN

Volume : V, Issue : IX, September - 2015

ANTIBACTERIAL SENSITIVITY OF BACTERIAL FLORA OF LOWER RESPIRATORY TRACT AFTER A WEEK OF TRACHEOSTOMY

Panduranga M Kamath, Vijendra Shenoy S, Aswin Mukundan, Suja Shreedharan

Abstract :

Objective: To evaluate the bacteriology of lower respiratory tract (LRT) and antimicrobial sensitivity following a week tracheostomy Materials and Methods: 70 patients who underwent tracheostomy for various indications from June 2013 to December 2014 were included in this time based study. Tracheal secretions were taken in all the cases and sent for culture and sensitivity. Specimens for culture and sensitivity were collected using a catheter which passes through the tracheostomy tube into the trachea and were analyzed at a single microbiological laboratory. Microbes were identified by their colonial morphology and characteristic biochemical tests Results: Out of 70 patients 56 patients (80%) had shown growth during the culture;Gram Negative Bacilli (AGNB), particularly Pseudomonas aeruginosa (48.6%) and Klebsiellapneumoniae(15.7%), Acenitobacter spp. in 6 patients while Methicillin Resistant Staphylococcus aureus (MRSA) was seen in 1 patient. About half of the pseudomonas was found to be resistant to cephalosporinsandmajority showing sensitivity to carbapenems and gentamicin. Acenitobacterwas found to be more sensitive to higher antibiotics like piperacilin–tazobactam and carbapenems only. Conclusion: GNB were the predominant isolates of LRT infections withPseudomonas aeruginosa andKlebsiellapneumoniae and as the commonest isolates. Patients with tracheostomy on prior injudicious antimicrobial therapy are at high risk for contracting lower respiratory tract infections due to resistant GNB.