Pathogens causing ventilator associated pneumonia and their antibiogram in a Tertiary Care Hospital in North Karnataka

Background: Ventilator associated pneumonia (VAP) is the most frequent intensive care unit acquired infection and is one of the leading causes of morbidity and mortality in ICUs. Objectives: To isolate and identify the causative organisms of ventilator associated pneumonia with their antibiotic susceptibility patterns in ICU patients of tertiary care hospital in North Karnataka. Methods: A prospective cohort study was conducted over one year period in ICUs of a tertiary care hospital in North Karnataka. ICU patients who were intubated and on mechanical ventilation for more than 48 hours, in whom VAP was clinically suspected {Clinical Pulmonary Infection Score (CPIS) > 6} were included in this study. Endotracheal aspirates and endotracheal tube tips after extubation were collected as samples. Quantitative culture threshold of more than 105cfu/ml was considered as diagnostic of VAP. Fifty one isolates were obtained from 47 samples as mixed growth was seen from 4 samples. Results: The incidence of VAP in our study was 47.00%. The most common isolates were Pseudomonas aeruginosa (31.38%), Staphylococcus aureus (27.46%), Acinetobacter (11.76%) and Escherichia coli (11.76%). Most of the gram negative bacteria isolated were sensitive to Imipenem and Cefoperazone - sulbactum and gram positive bacteria were sensitive to Vancomycin. Conclusion: The sensitivity patterns of gram negative bacteria and gram positive bacteria vary according to the ICU and the population studied. The recovery rate (78.94%) was higher in the early onset VAP cases. Late onset VAP had higher mortality (64.28%) when compared to the early onset VAP group (21.05%)

Prevalence of Mycobacterium tuberculosis with multiple copies of IS6110 elements in Gulbarga, South India

AbstractThis study was carried out to ascertain the prevalence of Mycobacterium tuberculosis by insertion sequence 6110 (IS6110) based DNA fingerprinting method in Gulbarga district belonging to the southern part of India. Results showed that among the 52 M. tuberculosis isolates studied, 57.7% exhibited more than 5 copies of IS6110 showing the prevalence of M. tuberculosis with multiple copies of IS6110 elements

Drug susceptibility profiles of Mycobacterium tuberculosis isolates from Gulbarga, South India

Aim of the work: Drug resistance surveillance is a useful tool to assess the effective functioning of tuberculosis (TB) control program. This study was undertaken to know the first line anti tuberculosis drug susceptibility profile of Mycobacterium tuberculosis clinical isolates from the Gulbarga district of South India. Methods: Drug susceptibility test was performed for 102 clinical isolates of M. tuberculosis belonging to new (n = 62), treated (n = 22) and unknown treatment category (n = 18) of TB. All the isolates were tested for susceptibility to first line anti-tuberculosis drugs by minimum inhibitory concentration (MIC) and resistance ratio method (for streptomycin). Results: The susceptibility profile of M. tuberculosis to all five first line anti-tubercular drugs was found to be 60.78% (62/102). Overall, multi drug resistance (resistance to at least isoniazid and rifampicin) was observed in 8.82% (9/102) isolates and was found to be higher for treated cases (18.18%). Conclusions: High level of drug resistance observed in new cases for isoniazid, rifampicin and ethambutol suggests need for the implementation of drug resistance surveillance studies in order to document the success of the tuberculosis control program in reducing the level of drug resistance