Hemalatha, S (2011) A Study on Aerobic Bacterial and Fungal Isolates in Bronchoalveolar Lavage in Patients with Lower Respiratory Tract Infection in a Tertiary Care Hospital. Masters thesis, Madras Medical College, Chennai.
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Abstract
Totally 100 samples of Bronchoalveolar fluid were analysed in detail. Bacterial and fungal isolates were found in 60 (60%) samples. • Male preponderance of lower respiratory tract infections was observed in this study. • The age group most commonly affected was between 41-60 years. • Pneumonia was found to be the most common lower respiratory tract infection. • Majority of the isolates were bacterial (78.3%) with gram negative bacilli (68.1%) being the most common. • Among the gram negative bacilli, Klebsiella spp. (Klebsiella pneumonia and Klebsiella oxytoca) (33.3%) was the most common followed by Pseudomonas aeruginosa and Acinetobacter baumanii (16.7% each). • Fungal isolates were less common (21.7%). The predominant fungal isolate was Candida albicans followed by Aspergillus spp. • Acid Fast Bacilli were found in 11% of the total samples. • All the bacterial isolates were sensitivie to Imipenem and majority of the isolates were sensitive to Amikacin. • Among the Staphylococcus aureus, 33.3% was methicillin sensitive and 66.7% was methicillin resistant. • All the 4 MRSA strains were sensitive to Vancomycin. • The incidence of ESBL producing Klebsiella spp. was 33.3% and Escherichia coli was 20%. • All the isolates of Candida spp. were sensitive to Amphotericin B and Itraconazole. 66.7% of Candida tropicalis showed resistance to Flucanazole by Disc Diffusion method. • All the isolates of Aspergillus spp. were sensitive to Amphotericin B by Broth Microdilution method. • Gram’s stain and 10% KOH mount procedures were found to be highly sensitive as rapid screening tests for isolating the bacterial and fungal isolates in Bronchoalveolar lavage. CONCLUSION: Lower respiratory tract infections are the major cause of morbidity and mortality worldwide. But the etiological agents were not determined in 50% of cases despite extensive diagnostic testings. Nowadays, analysis of Bronchoalveolar lavage plays a definite role in diagnosing pulmonary infections. On analysing the BAL fluid, Klebsiella spp. and Candida spp. were the most common bacterial and fungal isolates respectively. From the present study, the vital role of microbiological analysis of BAL fluid is clearly evident since the clinical features alone are not adequate to confirm infections. A simple Gram’s stain and KOH preparation were highly beneficial as rapid screening tests for diagnosis. Antimicrobial susceptibility testing was done for the bacterial and fungal isolates. Precise identification of the causative organisms and timely institution of appropriate antimicrobial therapy based on the prevailing sensitivity pattern of the bacterial and fungal isolates could reduce the morbidity and mortality of lower respiratory tract infections.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Aerobic Bacterial and Fungal Isolates, Bronchoalveolar Lavage, Lower Respiratory Tract Infection, Tertiary Care Hospital. |
| Subjects: | MEDICAL > Microbiology |
| Depositing User: | Subramani R |
| Date Deposited: | 23 Mar 2020 16:41 |
| Last Modified: | 18 Jun 2020 11:40 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/12438 |
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