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Spectrum of pathogens and their antimicrobial susceptibility pattern isolated from bronchoalveolar lavage specimens
Nidhi Negi1, Pankaj Rawat2, Iva Chandola3
1Department of Microbiology, Government Doon Medical College, Dehradun, Uttarakhand, India.
Background:
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.
Aims And Rationale Of The Study:
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.
Material And Methods:
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.
Results:
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.
Conclusion:
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.
Insights
This study identified Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter spp. as common causes of lower respiratory tract infections (LRTIs). Understanding bacterial resistance patterns is crucial for effective treatment of LRTIs.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Clinical Research
Background:
- Lower respiratory tract infections (LRTIs) cause significant illness and death, particularly in children and the elderly.
- Common bacterial pathogens in bronchoalveolar lavage (BAL) specimens include Streptococcus spp., Pseudomonas spp., and Klebsiella spp.
Purpose of the Study:
- To analyze bacterial isolates and antimicrobial resistance patterns in BAL fluid from hospitalized LRTI patients.
- To establish local antibiograms for improved antimicrobial stewardship.
Main Methods:
- Collected 200 BAL specimens from LRTI patients in various hospital wards and ICUs.
- Performed direct microscopy, culture, identification, and antimicrobial susceptibility testing on BAL specimens.
Main Results:
- Predominant isolates were Pseudomonas aeruginosa (41.02%), Klebsiella pneumoniae (17.94%), and Acinetobacter spp. (15.38%).
- High intermediate resistance to colistin was observed: P. aeruginosa (65%), K. pneumoniae (71%), and Acinetobacter spp. (83%).
Conclusions:
- Nonfermenting bacteria are significant in LRTI cases diagnosed via BAL.
- Accurate identification and resistance profiling of these isolates are vital for initiating appropriate empirical therapy.
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