Aneela Altaf Kidwai, Salma Razzaq, Qaiser Jamal, Sabeen Aatif, Saleemullah Paracha.
Antibiotic resistance among gram negative bacilli causing ventilator associated pneumonia.
Pak J Chest Med Jan ;17(3):11-6.

OBJECTIVE: To determine the microbial pattern and antimicrobial resistance among Gram- negative bacteria (GNB) recovered from patients with ventilator- associated pneumonia (VAP). MATERIALS & METHODS: An observational case control study was conducted in medical intensive care unit (MICU), having 15 beds, from January 2010 to December 2010. All the patients who remained ventilated for > 48 hours were prospectively followed for the occurrence of VAP. Deep tracheal aspirate were obtained for culture and Gram-stain and antibiotic resistance rate among Gram negative bacilli was documented. RESULTS: Ventilator associated pneumonia was identified in 54 (42.8%) patients. Gram negative bacilli were isolated from 77% specimens. Acinetobacter spp. (34%) followed by Pseudomonas aeruginosa (18%) were the most frequently isolated pathogens. All Acinetobacter spp. were resistant to ceftazidime (100%), amikacin (91%), ciprofloxacin 88% and to imipenem 86%. Isolates of Pseudomonas aeruginosa were resistant to ceftazidime 83% and 77% to ciprofloxacin. CONCLUSION: Ventilator associated pneumonia is predominantly caused by Gram negative bacilli. Ceftazidime, ciprofloxacin, imipenem and amikacin resistance rate were higher against Acinetobacter spp. Ceftazidime and ciprofloxacin resistant rates were also higher among other Gram- negative isolates.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com