Organisms isolated from endotracheal aspirate and their sensitivity pattern in patients suspected of ventilator associated pneumonia in a tertiary care hospital


  • Geetanjali Panda Department of Pulmonary Medicine, SCB Medical College and Hospital, Cuttack, India
  • Bishnu Prasad Mohapatra Department of Anaesthesiology, SCB Medical College and Hospital, Cuttack, India
  • Sidharth Sraban Routray Department of Anaesthesiology, SCB Medical College and Hospital, Cuttack, India
  • Rajat Kumar Das Acharya Harihar Regional Cancer Centre, Cuttack, India
  • Basant Kumar Pradhan Department of Anaesthesiology, SCB Medical College and Hospital, Cuttack, India



Endotracheal aspirate, Mechanical ventilation, Sensitivity, Ventilator associated pneumonia


Background: Ventilator associated pneumonia in critically ill patients are associated with high morbidity and mortality. Patients who are mechanically ventilated are at high risk of acquiring respiratory infections due to complex interplay between the endotracheal tube, host immunity and virulence of invading bacteria. To start empiric antimicrobial therapy knowledge of local antimicrobial resistance patterns are essential. Objectives of our study was to study antimicrobial sensitivity among organisms isolated from endotracheal aspirates of patients with VAP.

Methods: This is a prospective observational study, done in 100 patients who were mechanically ventilated for various reasons in ICU of our hospital over a period of one year. Clinical parameters, investigation, microbiological profile and sensitive characteristics of endotracheal aspirate was recorded and analyzed.

Results: Endotracheal aspirate culture and sensitivity was done in 100 patients.70 samples showed significant growth. Acinetobacter were isolated in 30 samples, Pseudomonas in 24, Klebsiella in 8, Enterobacter in 1, Citrobacter in 1 and Staphylococcus in 6 samples. Acinetobacter, Pseudomonas and Klebsiella were highly sensitive to colistin and polymyxin B, intermittently sensitive to meropenem and showed resistance to most of commonly used antibiotics.

Conclusions: The commonest organism isolated endo-tracheal aspirate cultures were Acinetobacter and Pseudomonas which was highly sensitive to colistin and polymyxin B. A local antibiogram for each hospital, based on bacteriological patterns and susceptibilities is essential not only to initiate empiric therapy but also to prevent poor outcomes and help in framing the appropriate institutional antibiotic policy.


Alp E, Voss A. Ventilator associated pneumonia and infection control. Annals Clinical Microbio Antimicro. 2006;5(1):7.

Erbay R H, Yalcin A N, Zencir M, Serin S, Atalay H. Costs and risk factors for ventilatorassociated pneumonia in a Turkish University Hospital's Intensive Care Unit: A case-control study. BMC Pulm Med. 2004;4:3.

National Nosocomial Infections Surveillance System Report: Data summary. Am J Infect Control. 2004;32:470-85.

Foglia E, Meier M, El-ward A. Ventilator-associated pneumonia in neonatal and pediatric intensive care units. Clin Microbiol Rev. 2007;20:409-25.

Miles RS, Amyes SG. Laboratory control of antimicrobial therapy. Mackie and McCartney practical medical microbiology. 1996;14:151-78.

Cinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; 17th informational supplement. CLSI document M100-S17(ISBN1- 56238-625-5). Clinical and Laboratory Standards Institute USA, 2014.

Sanjai, N, Paul, B, Stephen, B, Michael D, Mark, L, Gary D. Sampling variability in the microbiological evaluation of expectorated sputa and endotracheal aspirates. J. Clin. Microbiol. 2001;39:2344-7.

Tripathi S, Malik GK, Jain A. Study of ventilator associated pneumonia in neonatal intensive care unit: characteristics, risk factors and outcome. Internet J Med Update. 2010;5:12-9.

Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control. 1988;16:128-40.

Morehead RS, Pinto SJ. Ventilator-associated pneumonia. Archives Internal Medici. 2000;160(13):1926-36.

Ferrer M, Ioanas M, Arancibia F, Marco MA, de la Bellacasa JP, Torres A. Microbial airway colonization is associated with noninvasive ventilation failure in exacerbation of chronic obstructive pulmonary disease. Critical care Medic. 2005;33(9):2003-9.

Kumar AV, Pillai VS, Dinesh KR, Karim S. The phenotypic detection of Carbapenemase in meropenem resistant Acinetobacter calcoaceticus baumannii complex in a tertiary care hospital in south India. J Clin Diagn Res. 2011;5(2):223-6.

Drakulovic MB, Bauer TT, Torres A, Gonzalez J, Rodríguez MJ, Angrill J. Initial bacterial colonization in patients admitted to a respiratory intensive care unit: bacteriological pattern and risk factors. Respiration. 2001;68(1):58-66.

Mulla Summaiya A. Assessment of biofilm formation by the causative organisms of ventilator associated pneumonia at intensive care unit of a tertiary care hospital. Nat J Medic Res. 2012;2(1):15-8.

Patil, T. The Study of the organisms colonising trachea in mechanically ventilated patients admitted in the intensive care unit (ICU). International J Med Sci Edu. 2014;1(1):6.

George, P, Sequiera, A. Antimicrobial sensitivity pattern among organisms isolated from the endotracheal aspirates of patients with ventilator associated pneumonia. J Clin Diag Res. 2010;4: 3397-3401.

Standard Operative Procedures-Bacteriology. Antimicrobial Resistance Surveillance and Research Network, ICMR, New Delhi India. 2015:37.

Rakshith P, Nagar V S, Deshpande A K. Incidence, clinical outcome and risk stratification of VAP- A prospective cohort study. Indian J of Crit Care Med. 2005;9:211-6.

Andrade L, Vilela CAP, Cezario RC, Almeida AB, Filho PG. Ventilator Associated Pneumonia in an Adult Clinical- Surgical Intensive Care Unit of a Brazilian University Hospital: Incidence, Risk Factors, Etiology, and Antibiotic Resistance. Brazilian J Inf Dis. 2008;12:80-5.

Deja M, Spies C. Prevention measures of ventilator-associated pneumonia. Crit Care Med. 2009;37:330-2.




How to Cite

Panda, G., Mohapatra, B. P., Routray, S. S., Das, R. K., & Pradhan, B. K. (2017). Organisms isolated from endotracheal aspirate and their sensitivity pattern in patients suspected of ventilator associated pneumonia in a tertiary care hospital. International Journal of Research in Medical Sciences, 6(1), 284–288.



Original Research Articles