Prevalence of Drug Resistance Pattern in Bacterial isolates of Endotracheal secretion from Ventilator Associated Pneumonia in COVID-19 Suspected Patients

Abstract

Bacterial superinfections in ventilated COVID-19 patients has seen increase in mortality rates in COVID-19 pandemic. Hence, this study was designed to assess the presence of Drug resistant bacteria in COVID-19 suspected patients having symptoms of Ventilator associated Pneumonia (VAP) which can help to deescalate empirical antibiotics to evidence based and right antibiotic treatment. Objective: To assess prevalence of Drug resistant pattern of bacteria from endotracheal secretion in COVID-19suspected patients having Ventilator Associated Pneumonia. Methods: The current study was conducted in MGM Medical College & hospital, Maharashtra from January 2021 to March 2022. Endotracheal aspirate samples were obtained from the all COVID-19 suspected patients with VAP. Isolation, identification of all the bacteria were carried out using standard microbiological techniques (Morphological studies, Microscopy (Gram Staining) and Biochemical test like motility, catalase, Triple sugar Iron, Methyl Red, Urease, Citrate, oxidase and Indole were done). Antimicrobial susceptibility testing (AST) was done by Kirby- Bauer Disc Diffusion method using 0.5 McFarland suspension of each isolates and antibiotic disc. The results were interpreted in accordance with Clinical Laboratory Standard Institute recommendations. Results: Out of the 121 endotracheal secretions received from the VAP patients, 100 (82.64%) showed significant bacterial growth. 47 patients were COVID-19 positive and 53 were negative. Out of these 100 isolates 42% isolates were MDR (Multi Drug Resistance) &58% were XDR (Extensively Drug Resistance). More XDR bacteria were found in COVID-19 Positive patients as compared to COVID-19 negative patients. Bacteria isolated were Acinetobacterspecies, Klebsellia species, Pseudomonas species, Citrobacter species and others. Conclusions: The present study shows that more than 80% of the VAP cases in COVID-19 suspect patients are because of high prevalence of MDR and XDR bacteria. Timely testing of antimicrobial susceptibility is must in treatment of VAP patients as there is very limited Choice of antibiotics if the VAP is due to XDR bacteria.