Bacteriological Profiles of Trachealaspirates of Patients Attending National Institute of neurological and Allied Sciences

Abstract

National Institute of Neurological and Allied Sciences is the only super specialtyhospital in Nepal.The hospital was constructed to treat traumatic and seriously illNeurologicalpatientsand has saved life of several hundred such patients.Tracheostomyis performed to provide enough air to lung whenpatients cannot respire in normal way.The tracheostomised patients haveweakimmune system due toimpaired bronchociliaryescalator so they are colonized by gram negative aerobic bacteria which lead totracheobrochitis or pneumoniabut there was no data suggesting bacteriological profilein tracheal aspirates. So the aim of the study was to isolate and identify the potentialpathogen causing post tracheostomy infection. A prospective study was carried outduring April 2008-February 2009 based at National Institute of Neurological and AlliedSciences, Kathmandu. Tracheal aspirates of 50 tracheostomizedpatients were collectedand analyzed. Out of the 50 cases, 45 cases showed bacterial growth. Sixty sevenisolates were identified; some cases were poly-microbial (20,44.45%).Pseudomonasaeruginosaand enteric gram negativebacteria were most predominant bacteria (27;40.30%) followed by Staphylococcus aureus(7; 10.45%), Viridans Streptococus(2;2.98%) and other Gram negative bacteria (4; 5.96%).The isolates of P. aeruginosawere most sensitive to the Amikacin (81.48%, 22) followedby Ciprofloxacin (70.37%,19). All were resistant to the Cephotaxime. The isolates of enteric gram negativebacteria were sensitive to Amikacin and Chloramphenicol (74.07%) and all wereresistant to Ampicillin and Cephalexin. All the gram positive bacteria isolated weresensitive to Vancomycin. Among the total isolates, 88.88%(24 isolates) of P.aeruginosa, 66.66%(19 isolates) of enteric gram negative bacteria, and 55.55%(5isolates) of Gram positive bacteria were multi-drug resistant. The study showedalarming condition of MDR in tracheal aspirates indicating need of surveillance forMDR and timely intervention for control. Key words: Tracheal specimen, Bacteriological profile, MDR.