PATTERN OF BACTERIAL PATHOGENS ISOLATED FROM ENDOTRACHEAL SECRETIONS IN INTENSIVE CARE UNIT (ICU) PATIENTS OF A TERTIARY CARE HOSPITAL OF LAHORE
Objective: To determine the frequency and pattern of bacterial pathogens in tracheal secretions of patients who developed VAP during their stay in Lahore General Hospital.
Study design, Place and Duration of Study: This descriptive study was carried out in Lahore General Hospital, Lahore during January to December 2017.
Material and Methods: Endotracheal secretions from 445 patients on ventilator support were included in the study. Patients with fever ≥ 38 ˚C, WBCs count ≥ 10,000/mm3 or ≤ 3 000/mm3, purulent tracheal secretions and diffuse or patchy infiltration in chest radiograph were included in the study. After Gram staining, the samples were inoculated on blood and MacConkey agar with crystal violet, and incubated up to 48 hours at 37 ⁰C. The isolates were identified by standard microbiological procedures in laboratory.
Results: Out of 445 samples of tracheal secretions, 365 were collected from males and 80 from females. 370 samples (83%) yielded growth on culture. Of these, 75 (20.3%) were polymicrobial. The commonest isolate was Klebsiella pneumoniae. Other isolates included Pseudomonas aeruginosa, Acinetobacter spp., E. coli, Proteus spp. among Gram-negative bacteria and Staphylococcus aureus among Gram-positive bacteria.
Conclusion: Gram-negative bacilli are the commonest pathogens isolated from the endotracheal secretions of patients with ventilator-associated pneumonia.
Key Words: Tracheal secretions, ICUs, Ventilator associated pneumonia, Nosocomial infections.