Abstract
Introduction: Endotracheal tubes act as reservoir for pathogens by providing a surface for adherence and forming biofilms. Most ventilator-associated pneumonia is due to the dissemination of these biofilms into the mechanically ventilated lung. So this study will provide an idea about different bacteria that remained within the endotracheal tube and provide a reference for the selection of empirical antibiotic therapy.
Methods: A Descriptive cross-sectional study was conducted in the Microbiology laboratory of Lumbini Medical College. A total of 114 endotracheal tubes, sent from different ICU departments of Lumbini Medical College and Teaching Hospital, during one year from May 2022 to April 2023, were collected. Thus, the collected specimens were processed in the Microbiology lab for isolation of colonized bacteria. The antibiotic sensitivity test was performed for all isolates by the Kirby-Bauer disc diffusion method.
Results: Among the total 114 endotracheal tubes, 97 (85.05%) showed growth and 17 (14.91%) showed no growth. Seventeen specimens showed growth of two different bacteria, whereas 80 showed growth of only one. Among these isolates, 89 were Gram-negative bacilli and only 14 were Gram-positive cocci. Pseudomonas spp. 24(21.05%) was the most frequently isolated bacterium, followed by Klebsiella pneumoniae 23(20.17%) and Acinetobacter spp. 22(19.2%). Most Gram-negative bacilli were sensitive to Piperacillin Tazobactam, Imipenem, and Meropenem. Among 12 isolated Staphylococcus aureus, six were MRSA positive. MRSA showed sensitivity towards vancomycin and linezolid.
Conclusions: Pseudomonas spp, Klebsiella pneumoniae and Acinetobacter spp were the most common isolates with high resistance to most antibiotics.
References
Blot S, Ruppé E, Harbarth S, Asehnoune K, Poulakou G, Luyt CE, et al. Healthcare-associated infections in adult intensive care unit patients: Changes in epidemiology, diagnosis, prevention and contributions of new technologies. Intensive Crit Care Nurs. 2022;70(0):103227. PMID: 35249794 DOI: https://doi.org/10.1016/j.iccn.2022.103227
Shrestha R, Nayak N, Bhatta DR, Hamal D, Gokhale S, Parajuli S. Antibiogram profile of bacteria colonizing the endotracheal tubes (etts) of patients admitted to intensive care units (icus) in a tertiary care hospital of Nepal. Nepal Medical College Journal. 2021;23(3):241-6. DOI: https://doi.org/10.3126/nmcj.v23i3.36317
Papazian L, Klompas M, Luyt CE. Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Med. 2020;4695):888-906. PMID: 32157357 DOI: https://doi.org/10.1007/s00134-020-05980-0
Diaconu O, Siriopol I, Poloșanu LI, et al. Endotracheal Tube Biofilm and its Impact on the Pathogenesis of Ventilator-Associated Pneumonia. J Crit Care Med (Targu Mures). 2018 ;4(2):50-55. PMID: 30581995 DOI: https://doi.org/10.2478/jccm-2018-0011
Samal N, Padhi S, Paty BP. Bacteriological profile and antimicrobial sensitivity pattern of endotracheal tube aspirates of patients admitted in ICU. Journal of Dr. NTR University Health Sciences. 2020;9(3):151–7. DOI: https://doi.org/10.4103/JDRNTRUHS.JDRNTRUHS_118_20
Forbes BA, Sahm DF, Weissfeld AS. Bailey and Scott’s diagnostic microbiology, 12th ed. St. Louis (MO): Elesvier Mosby. 2007. 1031p. Available from: https://shop.elsevier.com/books/bailey-and-scotts-diagnostic-microbiology/forbes/978-0-323-03065-6
Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing: 31st edition. CLSI supplement M100 Wayne (PA): Clinical and Laboratory Standards Institute; 2021. Available from: https://www.treata.academy/wp-content/uploads/2021/03/CLSI-31-2021.pdf
Batool A, Ashiq S, Lone DS, Lone A, Ashiq K, Riaz S. Microbiological profile and antimicrobial susceptibility pattern of microorganisms isolated from endotracheal tube tips and tracheal aspirates specimens: A hospital based study. Journal of the Dow University of Health Sciences. 2020;14(1):32-7. DOI: https://doi.org/10.36570/jduhs.2020.1.929
Rajkumari S, Jha B, Adhikaree N. Bacteriological profile and antibiogram of endotracheal aspirates in patients admitted in neurosurgical intensive care unit at a tertiary care hospital. Journal of College of Medical Sciences- Nepal. 2020;16(3):152–6. DOI: https://doi.org/10.3126/jcmsn.v16i3.30662
Rathod VS, Sinha R, Shegokar VR, Munde BA, Saleha K. Bacteriological profile and antibiogram of endotracheal aspirates in intubated patients at a tertiary care hospital. International Journal of Health Sciences and Research. 2018;8(5):80–7. Available from: https://www.ijhsr.org/IJHSR_Vol.8_Issue.5_May2018/12.pdf
Swati A, Yamini K, Rajkumar RV. Microbiological spectrum and antimicrobial susceptibility patterns of various isolates from endotracheal tube aspirates in a tertiary care hospital, Hyderabad, Telangana. Indian Journal of Microbiology Research. 2018;5(2):202–7. DOI: https://doi.org/10.18231/2394-5478.2018.0043
Kaur K, Jindal S. Bacteriological profile and antimicrobial susceptibility pattern of endotracheal tube secretion of patients in ICUs of a tertiary care hospital in Punjab. Indian Journal of Microbiology Research. 2021;8(3):224–9. DOI: https://doi.org/10.18231/j.ijmr.2021.046
Ahmad H, Sadiq A, Bhatti HW, Bhatti AA, Tameez-Ud-Din A, Ibrahim A, et al. Bacteriological profile and antibiogram of cultures isolated from tracheal secretions. Cureus. 2019;11(6):e4965. PMID: 31453037 DOI: https://doi.org/10.7759/cureus.4965
Warang AD, Samant SA. Bacteriological profile of endotracheal aspirates from patients with lower respiratory tract infections and their antibiotic resistance pattern. Journal of Evolution of Medical and Dental Sciences. 2021;10(6):352-6. DOI: https://doi.org/10.14260/jemds/2021/79
Juayang AC, Maestral Jr DG, de los Reyes GB, Acosido MAD, Gallega CT. Review on the antimicrobial resistance of pathogens from tracheal and endotracheal aspirates of patients with clinical manifestations of pneumonia in Bacolod City in 2013. Int J Bacteriol. 2015;2015(0):942509. PMID: 26904750 DOI: https://doi.org/10.1155/2015/942509
Rashid O, Qayoom J, Khurshid S, Qadri R. Microbiological profile and the antimicrobial susceptibility pattern in endotracheal tube tip culture/ endotracheal aspirates of mechanically ventilated patients at a tertiary care hospital in Kashmir Valley: A cross sectional study. Journal of Advances in Medicine and Medical Research. 2022;34(4):26-31. DOI: https://doi.org/10.9734/jammr/2022/v34i431282
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 Nabina Maharjan, Raj Krishna Dangol