This work aimed to study the frequency of colonization ofintubated intensive care wit (ICU) patients in Benha university .hospital by anaerobic bacteria and their role in acquired ventilation associated pneumonia(VAP). This study was done on thirty five Patients (fourteen males and twenty one females) admitted to the intensive care unit of Benha University Hospital from December 2009 to September 2010, their age ranged from 16- 86 years old. Those patients were suffered from either epilepsy, cerebrovascular stroke (CVS), renal failure, respiratory failure and chronic obstructive pulmonary disease (COPD). All patients were mechanically ventilated. Two tracheal aspirate samples were taken from each patient using sterile disposable mucus extractor. Direct smears, Gram staining and anaerobic culture on Robertson cooked meat media for 24-48 hour were done. Subcultures were made anaerobically on the selective media i.e different selective blood agar and de man, Rogosa, sharpe (MRS) agar using the anaerobic gas pack jar. Identification of anaerobic bacterial species was done by using RaplD-ANA II system. Antibiogram was done for anaerobic bacterial isolates by disc diffusion method. Only ten ( 28.6%) out of thirty five mechanically ventilated patients in ICU gave positive result for anaerobic culture of tracheal aspirate samples taken within 24 hour of intubation. They were Peptostreptococci (34.6%), Clostridium (11.5%), Lactobacillius (30.6%) and Bacteroides (23.1%) . On the other hand, thirty two (91.4%) out of thirty five mechanically ventilated patients in ICU gave positive result of anaerobic culture for tracheal aspirate samples taken after 72 hour of intubation. They were Peptostreptococci (19.5%), Clostridium (7.8%), Lactobacillius (24.3%), Bacteroides (5.8%), Prevotella (15.5%), Fusobacterium (15.5%) and Veillonella(11.6%). The incidence of anaerobic isolates increase from (28.6%) in tracheal aspirate samples taken within 24 hour of intubation to reach (91.4%) in samples taken after 72 hour of intubation , a difference which is statistically highly significant (p< 0.001) . This means that the frequency of colonization by anaerobic organisms increase by prolonged intubation and so they may play a role in VAP. All isolated anaerobic strains were sensitive to metronidazole and resistant to ciprofloxacin and ceporex. |
