A Study on Bacterial and Fungal Isolates in Bronchoalveolar Lavage and their Antimicrobial Susceptibility Pattern in Clinically Diagnosed Patients with Interstitial Lung Disease Admitted in a Tertiary Care Hospital

Anitha, R (2017) A Study on Bacterial and Fungal Isolates in Bronchoalveolar Lavage and their Antimicrobial Susceptibility Pattern in Clinically Diagnosed Patients with Interstitial Lung Disease Admitted in a Tertiary Care Hospital. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION: Interstitial lung disease are a heterogenous group of parenchymal lung diseases characterized by progressive fibrosis of the lung parenchyma which results in diminished oxygen exchange between the alveolar walls. The use of corticosteroids for reducing the inflammatory process supress the immune system of the patients leads to lower respirtory tract infections that may worsen the condition of the patient. Current strategies for diagnosing the lower respiratory infections in favour the use of quantitative culture methods. Quantitative culture of bronchoalveolar lavage (BAL) fluid are important in the diagnosis of lower respiratory tract infections in Interstitial lung diseases, and serial dilution methods are commonly used to set up the cultures. AIM OF THE STUDY: The aim of this study is to do quantitative culture of bronchoalveolar lavage (BAL) samples in patients with Interstitial lung disease and to identify the non -tuberculous bacterial and opportunistic fungal aetiological agents in patients with Interstitial lung disease. MATERIALS AND METHODS: A total of 100 ILD patients were included in this study carried out at the Institute of Microbiology, Madras Medical College, in association with the Institute of Thoracic Medicine, Rajiv Gandhi Government General Hospital, and Chennai. RESULTS: Patients presents with ILD were identified and 100 BAL samples were collected through flexible fibreoptic bronchoscope and processed.41% of BAL samples showed significant bacterial growth and 15% showed growth in fungal culture. Twenty six patients had growth who had Connective tissue disorder as the associated risk factor. In bacterial culture of BAL samples showed gram negative bacteria 36% outnumbered gram positive cocci 5%, out of which Klebsiella spp. were isolated in high numbers 15%. Hyalohyphomycoses are grown more in BAL samples 8% and Aspergillus species are more commonly isolated in BAL samples than candida species. In this study, antimicrobial susceptibility testing was done for all the isolated organisms by Kirby - Bauer Disc Diffusion method as per CLSI guidelines. Antimicrobial susceptibility pattern of all Gram Negative bacterial isolates showed 100% susceptibility to Imipenam and Piperacillin- Tazobactum. The antimicrobial susceptibility pattern of Klebsiella pneumoniae showed 72.72% susceptible to Amikacin, 54.5% susceptibility to Cefotaxime, 81.81% susceptibility to Cefotaxime- Clavulanate, 72.72% susceptibility to Ciprofloxacin. In the present study, majority of the Gram Negative bacterial isolates were found to be more sensitive to Amikacin by 5 (71.42%) in E.coli, 8 (88.88%) in Pseudomonas aeruginosa, 4 (80%) in Acinetobacter baumannii, 8 (72.72%) in Klebsiella pneumoniae. CONCLUSION: ILD was mostly associated with Connective tissue disorders and Gram Negative bacteria especially Klebsiella species were the most common cause of infections in these patients. Aspergillus species were the most common fungus isolated from BAL samples in ild patients.Most of the Gram Negative bacteria were ESBL producers which was detected predominantly in Klebsiella species which stresses upon the need for judicious use of antibiotics in ILD patients. Early diagnosis and appropriate treatment and patient compliance are the major factors influencing the outcome of lung infections. Thus BAL samples helps in early diagnosis and management of Interstitial lung diseases.

Item Type: Thesis (Masters)
Additional Information: Reg.No.201414002
Uncontrolled Keywords: Bacterial and Fungal Isolates, Bronchoalveolar Lavage, Antimicrobial Susceptibility Pattern, Clinically Diagnosed Patients, Interstitial Lung Disease, Tertiary Care Hospital.
Subjects: MEDICAL > Microbiology
Depositing User: Subramani R
Date Deposited: 18 Jul 2020 17:38
Last Modified: 19 Jul 2020 04:36
URI: http://repository-tnmgrmu.ac.in/id/eprint/12550

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