scholarly journals PREVALENCE AND ANTIBIOTIC SENSITIVITY PATTERN OF BACTERIA CAUSING LOWER RESPIRATORY TRACT INFECTION IN THE GERIATRIC GROUP

2020 ◽  
pp. 1-3
Author(s):  
Abarna. V ◽  
Vani. V ◽  
Lavanya. S ◽  
Kamatchi. S

Abstract Introduction: Lower respiratory tract infections accounts for 3% -5% of mortality in adults, especially in the geriatric age group. Aim: To know the prevalence of various microorganisms causing LRTI in geriatric patients, studying their antibiotic sensitivity pattern and to determine the various risk factors in this age group. Materials & methods: Sputum samples were collected from 50 geriatric patients. Other Co-morbid conditions were evaluated. Isolated pathogens were tested for antibiotic sensitivity pattern by standard microbiological methods. Results: Among 50 patients, 9(18%) Chronic Obstructive Pulmonary Disease (COPD), 7(14%) of them had Pulmonary tuberculosis, 7(14%) Bronchial Asthma, and the remaining 27(54%) with other lower respiratory tract infections. 41(82%) samples were culture positive. Organisms like Klebsiella pneumoniae (20), Pseudomonas aeruginosa (10), Candida spp (3) E. coli (2), Staphylococcus aureus (4), Acinetobacter (1), Enterococcus (1), were grown. Conclusion: The prevalence of multi drug resistant bacteria causing lower respiratory tract infection is increasing, now-a-days. Changing lifestyle patterns like avoiding of smoking, glycemic control in diabetics, avoiding sedentary lifestyle with adequate physical activity and appropriate diet would improve the immune status of the geriatric patients and thereby reduces all possible infections in this age group. Knowing the sensitivity pattern of isolated pathogens and then treating the patients will reduce the incidence of drug resistant microorganisms as well.

2021 ◽  
Vol 10 (35) ◽  
pp. 2964-2968
Author(s):  
Swetha Thirumurthi ◽  
Priya Kanagamuthu ◽  
Rajasekaran Srinivasan ◽  
Bhalaji Dhanasekaran

BACKGROUND The term tracheostomy refers to forming an opening in the trachea.1,2 Its advantages include easy and direct access to lower respiratory tract, reduced risk of aspiration, faster weaning from ventilation support and improved physical and psychological comfort. But a common problem in tracheostomised patients is increased risk of colonisation of lower respiratory tract by exogenous bacteria because of direct exposure.1,3 This study was done to recognise pathogens in tracheal secretions collected from tracheostomised patients and their antibiotic sensitivity to treat them with appropriate antibiotics. METHODS This prospective study was done in 138 tracheostomised patients from October 2020 to March 2021 in intensive care unit (ICU) of Chettinad Hospital and Research Institute. Under sterile aseptic precautions, Day 0 and Day 7 cultures posttracheostomy was obtained and their antibiotic sensitivity was studied. Data was analysed using Statistical Package for Social Sciences (SPSS version 19) and presented in proportion, mean and standard deviation (Descriptive statistics). RESULTS In this study, of the 56 cases who had growth in their culture and sensitivity reports on day 0, the most common organism was Pseudomonas aeruginosa (33.9 %) sensitive to imipenem (94.7 %) followed by klebsiella (25 %) sensitive to teicoplanin, vancomycin, amikacin, cefoperazone/tazobactam, linezolid and piperacillin/tazobactam. On day 7, the growth of organisms isolated in tracheal culture got reduced from 56 cases to 16 cases. The prevalence of Pseudomonas reduced to 18.8 % in day 7 whereas Klebsiella pneumonia and Acinetobacter remained almost same from day 0 to day 7. CONCLUSIONS This study concludes the predominant pathogen as Pseudomonas aeruginosa with sensitivity to imipenem followed by Klebsiella with sensitivity to teicoplanin, vancomycin, amikacin, cefoperazone/tazobactam, linezolid and piperacillin/tazobactam on day 0 with reduction in the number of organisms on day 7 due to the fact that all our patients were admitted in ICU several days prior to tracheostomy and were started on antibiotics soon after admission as per choice of the treating physician. Hence, a clear understanding of bacterial colonisation post tracheostomy and its change in course is essential for timely intervention with empirical antibiotics for reducing the incidence of lower respiratory tract infections after tracheostomy in future. KEY WORDS Tracheostomy, Lower Respiratory Tract Infections, Pseudomonas Aeruginosa, Empirical Antibiotics.


2013 ◽  
Vol 5 (1) ◽  
pp. e2013056 ◽  
Author(s):  
Gamal Agmy ◽  
Sherif Mohamed ◽  
Yaser Gad ◽  
Essam Farghally ◽  
Hamdy Mohammedin ◽  
...  

BACKGROUND: Lower respiratory tract infections (LRTI) account for a considerable proportion of morbidity and antibiotic use. We aimed to identify the causative bacteria, antibiotic sensitivity and resistance of hospitalized adult patients due to LRTI in Upper Egypt. METHODS: A multicentre prospective study was performed at 3 University Hospitals for 3 years. Samples included sputum or bronchoalveolar lavage (BAL) for staining and culture, and serum for serology. Samples were cultured on 3 bacteriological media (Nutrient, Chocolate ,MacConkey's agars).Colonies were identified via MicroScan WalkAway-96. Pneumoslide IgM kit was used for detection of atypical pathogens via indirect immunofluorescent assay. RESULTS: The predominant isolates in 360 patients with CAP were S.pneumoniae (36%), C. pneumoniae (18%), and M. pneumoniae (12%). A higher sensitivity was recorded for moxifloxacin, levofloxacin, macrolides, and cefepime. A higher of resistance was recorded for doxycycline, cephalosporins, and β-lactam-β-lactamase inhibitors. The predominant isolates in 318 patients with HAP were, methicillin-resistant Staphylococcus aureus; MRSA (23%), K. pneumoniae (14%), and polymicrobial in 12%. A higher sensitivity was recorded for vancomycin, ciprofloxacin, and moxifloxacin. Very high resistance was recorded for β-lactam-β-lactamase inhibitors and cephalosporins. The predominant organisms in 376 patients with acute exacerbation of chronic obstructive pulmonary diseases (AECOPD) were H. influnzae (30%), S. pneumoniae (25%), and M. catarrhalis(18%). A higher sensitivity was recorded for moxifloxacin, macrolides and cefepime. A higher rate of resistance was recorded for aminoglycosides and cephalosporinsCONCLUSIONS: The most predominant bacteria for CAP in Upper Egypt are S. pneumoniae and atypical organisms, while that for HAP are MRSA and Gram negative bacteria. For acute exacerbation of COPD,H.influnzae was the commonest organism. Respiratory quinolones, macrolides, and cefepime are the most efficient antibiotics in treatment of LRTI in our locality.


1996 ◽  
Vol 40 (12) ◽  
pp. 2765-2768 ◽  
Author(s):  
J J Roord ◽  
B H Wolf ◽  
M M Gossens ◽  
J L Kimpen

The efficacies and safeties of a 3-day, 3-dose course of azithromycin (10 mg/kg of body weight per day) and a 10-day, 30-dose course of erythromycin (40 mg/kg/day) for the treatment of acute lower respiratory tract infections in children were compared in an open randomized multicenter study. Sixty-eight of 85 evaluable patients (80%) had radiologically proven pneumonia, and 20% had bronchitis. Treatment success defined as cure or major improvement was achieved in 42 of 45 (93%) azithromycin recipients versus 36 of 40 (90%) erythromycin recipients. Adverse events were reported in 12 of 45 and 6 of 40 of the patients treated with azithromycin and erythromycin, respectively, a difference which was not statistically significant. In conclusion, a 3-day course of azithromycin is as effective as a 10-day course of erythromycin in the treatment of community-acquired lower respiratory tract infections in children, with comparable safety and acceptability profiles. This shorter treatment course might have a beneficial effect on compliance, especially in the pediatric age group.


Author(s):  
Apoorva T Raju ◽  
Rojaleen Das ◽  
Nikki Rai ◽  
Ajay Kumar ◽  
Rajni Gaind

Introduction: The lower respiratory tract infections are a major cause of mortality in children below five years of age. Majority of the time the infection is self-limiting but often gets severe and fatal depending on various factors like age, aetiology, time of diagnosis, appropriate treatment, etc. Aim: To study viral aetiology of Acute Lower Respiratory tract Infections (ALRI) using multiplex real time qualitative Polymerase Chain Reactions (qPCR) among hospitalised children under five years of age. Materials and Methods: This was a hospital based prospective study conducted over a period of two years from June 2015 to May 2017, a throat and nasal swab was collected from 512 children ≤5 years who were being hospitalised for ALRI. The samples were tested by multiplex qPCR to detect viral and p<0.05 was considered as statistically significant. Results: Out of 512 cases, 317 children were further studied. It was found that highest number of ALRI were observed in children of age less than six months i.e., 38.9% followed by 29.4%, 14.8% and 16.9% in the age group of 6-12 months, 12-24 months and 24-60 months, respectively. The one/more viral pathogens were detected in 58.3% (185/317) children. Respiratory Synctial Virus (RSV) was most common virus detected in 51.9% followed by Human Rhinovirus (HRV) in 23.2%. RSV was found to be statistically significant in infants and causes very severe ALRI. Conclusion: The use of multiplex qPCR has clarified the scenario of different respiratory viral aetiologies causing ALRI in different age group of children. The study results enhance knowledge for making strategy to prevent severity of ALRI in different age group, seasons and geographical area.


2021 ◽  
Vol 8 (24) ◽  
pp. 2077-2082
Author(s):  
Satheesh Chandra Sugatha Rao ◽  
Shara Beena

BACKGROUND Lower respiratory tract infections are the most common bacterial infections in neurosurgery intensive care units (NSICU), resulting in high overall mortality. The emergence of antibiotic resistant pathogens poses a challenge to their empiric treatment. Regular surveillance of the prevalent strains and their susceptibility pattern, helps to revise the antibiotic policies and aids in better management of the patient. METHODS A cross sectional study was conducted in the Department of Neurosurgery and Microbiology, Government Medical College, Thrissur, over a period of 1 year, using lower respiratory tract specimens of 190 patients with acute respiratory symptoms admitted in neurosurgery intensive care unit. The specimens collected aseptically were processed immediately. Following culture, the bacterial isolates were identified using standard methods and antibiotic susceptibility was done by Kirby Bauer disc diffusion method. The data obtained was coded and entered in Microsoft Excel and expressed as percentage. RESULTS Bacterial isolates were obtained from 74 % samples. 82 % isolates were monomicrobial and 18 % were polymicrobial. Majority of the isolates were gram negative bacteria (94 %) followed by gram positive bacteria (6 %). The common gram-negative isolates were K. pneumoniae (36 %), A. baumannii (29 %), P. aeruginosa (20 %). Methicillin-resistant staph (MRSA) (3 %) and methicillinsusceptible staph (MSSA) (3 %) accounted for the gram positive cocci. 61 % isolates were multi drug resistant (MDR). Most common MDR organism was A. baumannii. It was observed that 26 % isolates were extended spectrum betalactamase (ESBL) producers. A high rate of resistance to cephalosporins, beta lactams, fluoroquinolones, aminoglycosides, and cotrimoxazole was observed. An emerging resistance to carbapenems was observed. CONCLUSIONS Proper microbiological work up and antibiotic stewardship programmes can limit spread of resistant organisms, thereby reducing the medical and economic burden of the patient. KEYWORDS Lower Respiratory Tract Infection, Neurosurgery ICU, Antimicrobial Susceptibility Tests, Multi Drug Resistant Organisms


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