Journal of Education and Health Promotion

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

Document Type : Original Article

Authors

. Mohan Bilikallahalli Sannathimmappa 1
. Vinod Nambiar 2
. Rajeev Aravindakshan 3
. Nashwa M. Al‑Kasaby 4

1 Department of Microbiology and Immunology, College of Medicine and Health Sciences, National University of Science and Technology, Oman

2 Department of Microbiology and Immunology, College of Medicine and Health Sciences, National University of Science and Technology, Oman,

3 Department of Community Medicine, All India Institute of Medical Sciences, Andhra Pradesh, India

4 Department of Pathology, Sohar Hospital, Ministry of Health, Oman 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
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Journal of Education and Health Promotion
Volume 11, Issue 4
May 2021
Pages 1-7

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