Negi Nidhi, Rawat Pankaj, Chandola Iva, Husain Uneza, Priyadarshi Ketan
Department of Microbiology, Government Doon Medical College, Dehradun, Uttarakhand, India.
Department of Microbiology, Gautam Buddha Chikitsa Mahavidyalaya, Dehradun, Uttarakhand, India.
J Family Med Prim Care. 2024 Jan;13(1):66-69. doi: 10.4103/jfmpc.jfmpc_327_23. Epub 2024 Feb 8.
Lower respiratory tract infections (LRTIs) are associated with significant morbidity and mortality in all age groups, especially young children and the elderly population. Various gram-positive and gram-negative organisms such as Streptococcus spp., Pseudomonas spp., and Klebsiella spp. have been implicated as a pathogen in bronchoalveolar lavage (BAL) specimens collected from such patients.
The present study is aimed at assessing the spectrum of the bacterial isolates and determining the antimicrobial resistance obtained from the BAL fluid from admitted patients at various wards and intensive care units (ICUs) of a tertiary care hospital in Dehradun. This will be the stepping stone in our efforts toward becoming a future antimicrobial steward and framing local antibiograms based on such data.
Two hundred BAL specimens were collected from patients admitted to various wards and ICUs of the hospital who were suffering from LRTI. The BAL specimens were subjected to direct microscopy and culture. Identification and susceptibility testing were performed.
The most predominant isolates were Pseudomonas aeruginosa (16/39 (41.02%)) followed by Klebsiella pneumoniae (7/39 (17.94%)) and Acinetobacter spp. (6/39 (15.38%)). Sixty-five percentage of Pseudomonas aeruginosa, 71% of Klebsiella pneumoniae, and 83% of Acinetobacter spp. showed intermediate results with colistin.
Nonfermenters constitute a significant group of organisms isolated from bronchoalveolar lavage (BAL) specimens in patients with lower respiratory tract infections (LRTIs). Hence, it is extremely important to correctly identify and determine the resistance pattern of such isolates so that appropriate empirical therapy can be initiated for the benefit of the patient.
下呼吸道感染（LRTIs）在所有年龄组中都与显著的发病率和死亡率相关，尤其是幼儿和老年人群。各种革兰氏阳性和革兰氏阴性菌，如链球菌属、假单胞菌属和克雷伯菌属，已被认为是从此类患者采集的支气管肺泡灌洗（BAL）标本中的病原体。
本研究旨在评估一所位于德拉敦的三级医院各个病房和重症监护病房（ICU）收治患者的BAL液中分离出的细菌谱，并确定其抗菌药物耐药性。这将是我们努力成为未来抗菌药物管理机构并基于此类数据制定本地抗菌谱的基石。
从该医院各个病房和ICU收治的患有LRTI的患者中采集了200份BAL标本。对BAL标本进行直接显微镜检查和培养，并进行鉴定和药敏试验。
最主要的分离菌株是铜绿假单胞菌（16/39（41.02%）），其次是肺炎克雷伯菌（7/39（17.94%））和不动杆菌属（6/39（15.38%））。65%的铜绿假单胞菌、71%的肺炎克雷伯菌和83%的不动杆菌属对黏菌素呈现中介结果。
非发酵菌是下呼吸道感染（LRTIs）患者支气管肺泡灌洗（BAL）标本中分离出的重要菌群。因此，正确鉴定并确定此类分离菌株的耐药模式极为重要，以便为患者启动适当的经验性治疗。
