A STUDY ON DETECTION OF BACTERIAL AND FUNGAL ISOLATES IN BRONCHO ALVEOLAR LAVAGE FLUID SPECIMEN WITH A SPECIAL MENTION ON ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF BACTERIAL ISOLATES

Abstract

Introduction:Chronic respiratory diseases are a group of chronic disease affecting the airways and other structures of lungs. Common causes of infections in these patients are viruses, bacteria and fungi4. Respiratory Tract Infection (RTI) is by large one of the leading causes of the morbidity and mortality in the world3. Early diagnosis and proper choice of antimicrobials is crucial for management of these patients. Aims and objectives:The Aims and Objectives of this study, is to identify the bacteriological and mycological isolates in Broncho-alveolar lavage fluid and detect antimicrobial susceptibility pattern of bacterial isolates. Materials and Methods:A total of 203 Broncho-alveolar lavage fluid in paired samples obtained from patients were analyzed.The pathogens were identified and speciated by using the set of biochemical reactions as per standard reference. Results:This prospective study was done for a period of twelve months (September 2017 to August 2018) with 203 Broncho-alveolar lavage fluid samples. Growth was observed in 115 samples (56.65%). Of the culture positive samples, 77(67%) were bacterial, 21(18%) samples were mycobacterium tuberculosis and 17 (16%) were fungal isolates. The most common bacterial isolate was Klebsiellapneumoniae (28.57%), followed by Staphylococcus species (24.64%), Escherichia coli (20.77%), Pseudomonas species (14.28%), and Acinetobacter species (11.68%). Among the Staphylococcus aureus isolates,40% were Methicillin resistant and 60% were Methicillin sensitive.The fungal isolates were Candida(35.29%),Aspergillus(29.41%),(17.64%),Penicillium(11.76%)and Paecilomyces (5.88%). Conclusion:Systematicculture of BAL fluidgives a definite diagnosis of chronic pulmonary infections which would guide in selection of appropriate antimicrobials for management of pneumonia..A study like this would help and guide the physicians in prescribing the right combinations of anti-microbial to limit and prevent the emergence of multi-drug resistant strains of Bacteria.