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

ABSTRACT Context: Respiratory infections have been linked to increased mortality and morbidity rates in patients in the intensive care unit (ICU). The interaction between the endotracheal tube, the patient’s immune system, and the strength of the pathogens is intricate and significant in patients receiving mechanical ventilation, as they are more vulnerable to respiratory infections. Aims: The primary goal of this study is to identify the specific bacteria present in endotracheal tubes and to analyse their antibiotic sensitivity patterns and resistance in patients undergoing mechanical ventilation in the ICU. This will enable us to facilitate the initiation of appropriate empirical treatment for these patients. Settings and Design: The study was a retrospective review of patients who were put on ventilator at Dr. VRK Teaching Hospital and Research Centre between January 2022 and December 2022. Methods and Material: Samples for microbiological cultures were obtained from ETA secretions and also from the cut end of ET tube were sent to the central laboratory for further assessment. Antibiogram and microbiological cultures were obtained for each sample. Statistical Analysis Used: Data were collected using a Microsoft Excel sheet and were analyzed with SPSS software (24 th version). Results: In this study of 217 positive culture samples, 134 participants were male (61.8%) and 83 female (38.2%), with the highest isolation rates in patients over 60 years old (50%). Gram-negative organisms were predominant (79%), with Klebsiella pneumoniae being the most frequently isolated (75%), followed by A. baumannii (12%) and P. aeruginosa (10%). Among gram-positive organisms, methicillin-resistant Staphylococcus aureus (MRSA) was the most common (21%). Most gram-negative isolates were sensitive to Tigecycline, carbapenems, Gentamicin, and Colistin, but resistant to Amoxyclav, Ceftazidime, and Cefepime. All gram-positive samples were MRSA, sensitive only to Vancomycin, Teicoplanin, Linezolid, and Gentamicin, and resistant to Ciprofloxacin, levofloxacin, and penicillin. The study highlights Klebsiella as the most prevalent microorganism from endotracheal tubes and emphasizes the need for strict antibiotic policies and effective infection control measures to combat multi-drug-resistant organisms. Conclusions: In conclusion, our study identifies Klebsiella as the most common microorganism in endotracheal tubes of critically ill patients, with Amoxyclav and Cefepime showing significant antibiotic resistance. Most microorganisms were sensitive to Tigecycline and Carbapenems. Therefore, a comprehensive strategy involving strict antibiotic policies and effective infection control measures is essential to combat multidrug-resistant organisms and manage infection outbreaks.