PURPOSE: In ventilator associated pneumonia (VAP), the surveillance of endotracheal aspirate (ETA) cultures have been shown to have a good predictive value in identifying its etiology. The purpose of this study is to identify and evaluate the trend of common bacterial isolates on surveillance ETA cultures and their antibacterial susceptibility in our community Hospital.
METHODS: We retrospectively reviewed the surveillance endotrachial aspirate cultures of intubated patients admitted to ICU in 2003 and 2007. The microbiology and antibacterial susceptibility pattern of the most frequent isolates was compared.
RESULTS: In 2003 out of 69 ETA cultures; Acinetobacter baumanii was isolated from 25 patients (36 %), Pseudomonas Aeruginosa from 18 (26%), Klebsiella Pneumoniae from 7 (10%) and Meticilline resistant S aureus (MRSA) from 5 (7.2%). The rest was accounted by MSSA, E Coli, Citrobacter, B hemolytic streptococcus and Proteus Mirabilis. In 2007 out of 79 ETA cultures; Acinetobacter baumanii was isolated from 31 patients (39%), Pseudomonas Aeruginosa from 18 (22.7%), MRSA from 13 (16.5%), and the rest was accounted by Klebsiella Pneumoniae, P Stuartti, M Morgagni, S Marscences and E Coli. In 2003, out of 25 isolates of Acinetobacter baumanii; 18 (72%) were susceptible to Imipenem, 14(56%) were susceptible to Amikacin, 7 (28%) were susceptible to Trimetoprim Sulfametoxazole, and 7(28%) were susceptible to Ampicillin Sublactam. In 2007, out of 31 isolates of Acinitobacter baumanii, 26 (83%) were susceptible to Imipenem, 22 (70%) were susceptible to Amikacin, 9 (29%) were susceptible to Trimetoprim sulfamethoxazole and 9 (29%) were susceptible to Ampicillin Sublactam. In both years, Acinetobacter baumanii was universally resistant to Levofloxacin, Ciprofloxacine, Cefipime and Piperacilline Tazobactam.
CONCLUSION: Multi drug resistant Acinitobacter Baumanii, P Aeruginosa and MRSA remained the commonest isolates of ETA cultures in our community hospital and their antibacterial susceptibility remained unchanged in the last 5 years.
CLINICAL IMPLICATIONS: Imipenem should be used for empirical therapy on VAP in our Hospital based on this study.
DISCLOSURE: Bedilu Woldaregay, No Financial Disclosure Information; No Product/Research Disclosure Information