AEROBIC BACTERIAL PROFILE AND ANTIBIOGRAM OF BRONCHOALVEOLAR LAVAGES IN PULMONARY INFECTIONS AT A TERTIARY CARE HOSPITAL
DOI:
https://doi.org/10.22159/ijcpr.2023v15i4.3016Keywords:
Infections, Isolates, Bacterial, Bronchoalveolar, AntibioticAbstract
Objective: Lower respiratory tract infections (LRTIs) are one of the common clinical problems in community and hospital settings and the commonest causes of morbidity and mortality. In pulmonary infections, BAL fluid sample has high sensitivity and reliability in diagnosis. To determine the distribution of bacterial isolates in BAL samples and antibiotic sensitivity patterns in most frequently isolated bacterial pathogens other than Mycobacterium tuberculosis.
Methods: The study was conducted on 218 BAL samples received in the microbiology laboratory, Andhra Medical College from various wards of King George Hospital; Visakhapatnam; Andhra Pradesh, over a period of one year (from January 2022 to December 2022). All samples were processed according to standard microbiology protocols. Antimicrobial susceptibility was tested by the Kirby-Bauer disc diffusion method as per the CLSI guidelines 2022.
Results: Total 218 BAL samples were studied. Among 218 BAL samples, 144(66%) samples were from male patients and 74(34%) samples from female patients. Out of 218 samples, 119(55%) were culture positive and 99(45%) were culture negative. Among 119 bacterial isolates, most predominant pathogen was Klebsiella pneumoniae 51(42.8%) followed by Pseudomonas aeruginosa 46(38.6%), Escherichia coli 11(9.2%), Enterobacter species 6(5.0%), Acinetobacter species 3(2.5%) and Staphylococcus aureus 2(1.68%). Out of these isolated pathogens, Gram-negative bacilli were more. These gram-negative isolates were most sensitive to Piperacillin-Tazobactam (74.3%) followed by Meropenem (71.7%), Amikacin (60.6%) and least sensitive to Ceftazidime (39.3%) and Cefotaxime (37.6%).
Conclusion: The present study shows that gram-negative bacilli were more commonly isolated in BAL samples and the bacterial isolates were most sensitive to Piperacillin-Tazobactam and Meropenem and highly resistance to Cefotaxime and Ceftazidime. Hence, formulating a regular antibiogram in hospitals will help in developing local antibiotic policies, which may provide better patient management and judicious use of antibiotics by clinicians to prevent the risk of the emergence of multidrug-resistant pathogens.
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References
Jaroszewski DE, Webb BJ, Leslie KO. Diagnosis and management of lung infections. Thoracic Surgery Clinics, Surgical Management of Infectious Pleuropulmonary Diseases. 2012 Aug;22(3):301-24. doi: 10.1016/j.thorsurg.2012.05.002.
Radha S, Afroz T, Prasad S, Ravindra N. Diagnostic utility of bronchoalveolar lavage. J Cytol. 2014 Jul;31(3):136-8. doi: 10.4103/0970-9371.145636, PMID 25538381.
Padmaja N, Rao V. Bacteriological profile and antibiogram of bronchoalveolar lavage fluid from patients with respiratory tractinfections at a tertiary care Hospital. Indian J Microbiol Res. 2021;8(2):119-22. doi: 10.18231/j.ijmr.2021.023.
Bari SA, Mustafa M. A study on bacterial isolates from bronchoalveolar lavage (BAL) fluid obtained from patients with pulmonary infections in tertiary care hospital, Hyderabad. Int J Recent Sci Res. 2018 Jun;9(6):27531-5, doi: 10.24327/ijrsr.2018.0906.2279.
Ku DV, Kumar DM DN. Microbiological profile of bronchoalveolar lavage fluid in patients with chronic respiratory diseases: a tertiary care hospital study. Int J Med Res Rev. 2016;4(3):330-7. doi: 10.17511/ijmrr.2016.i03.08.
Adhikari S, Regmi RS, Pandey S, Paudel P, Neupane N, Chalise S. Bacterial etiology of bronchoalveolar lavage fluid in tertiary care patients and antibiogram of the isolates. J Inst Sci Tech. 2021;26(1):99-106. doi: 10.3126/jist.v26i1.37833.
Magazine R, Rao S, Chawla K, Chogtu B. Bacterial isolates from the bronchoalveolar lavage fluid of patients with pneumonia not responding to initial antimicrobial therapy. Sahel Med J. 2013 Jan 1;16(3):102. doi: 10.4103/1118-8561.121914.
Vishwanath S, Chawla K, Gopinathan A. Multidrug-resistant gram-negative bacilli in lower respiratory tract infections. Iran J Microbiol. 2013 Dec;5(4):323-7. PMID 25848499.
R RI, BS. Bacteriological profile and antibiotic susceptibility patterns of lower respiratory tract infections in a tertiary care hospital, Central Kerala. IJMMTD. 2020;4(4):186-90. doi: 10.18231/2581-4761.2018.0040.
Ghanem MK, Makhlouf Hoda A, Hasan AA, Rashed HG, Khalifa HS. Bacteriological profile of critically ill patients with chronic obstructive pulmonary disease in respiratory Intensive Care Unit in Assuit University Hospital. Egypt J Bronchol. 2019 Sep;13(3):343-8. doi: 10.4103/ejb.ejb_83_18.
Panda S, Nandini BP, Ramani TV. Lower respiratory tract infection–bacteriological profile and antibiogram pattern. Int J Curr Res Rev. 2012;4(21):149-55.
V Ramana K, Kalaskar A, Rao M, D Rao S. Aetiology and antimicrobial susceptibility patterns of lower respiratory tract infections (LRTI) in a Rural Tertiary Care Teaching Hospital in Karimnagar, South India. Am J Infect Dis Microbiol. 2013 Jan 23;1(5):101-5. doi: 10.12691/ajidm-1-5-5.
Ahmed SM, Jakribettu RP, Meletath SK, BA, Vpa S. Lower respiratory tract infections (LTRIs): an insight into the prevalence and the antibiogram of the Gram-negative, respiratory, bacterial agents. J Clin Diagn Res. 2013 Feb;7(2):253-56. doi: 10.7860/JCDR/2013/5308.2740, PMID 23543819.
Ravichitra KN, Subbarayudu S. A study on the etiological trends and antibiogram of lower respiratory tract infections (LRTIs) at a tertiary Care Hospital. Int J Curr Microbiol App Sci. 2016 Dec 15;5(12):18-22. doi: 10.20546/ijcmas.2016.512.003.
Duan N, Du J, Huang C, Li H. Microbial distribution and antibiotic susceptibility of lower respiratory tract infections patients from the pediatric ward, adult respiratory ward, and respiratory intensive care unit. Front Microbiol. 2020;11:1480. doi: 10.3389/fmicb.2020.01480, PMID 32695092.
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