Resistance patterns of the isolates of ventilator associated pneumonia and associated risk factors in a tertiary care hospital of Pakistan

Abstract

Background: Blindness and eye disorders represented a problem of major public health concern in Pakistan. Bacterial keratitis (Corneal ulcer) is an inflammatory disease of the cornea caused by bacterial infections. Bacterial keratitis is a significant cause of ocular morbidity that can result in severe visual loss and should be considered a medical emergency. Endophthalmitis is a severe inflammation of the anterior and posterior segments of the eye caused by the introduction of contaminating microorganisms following trauma, surgery, or hematogenous spread from a distant infection site. Methods & Materials: A prospective study was performed to analyze trends in resistance of Keratitis and endophthalmitis causativebacteria to commonlyusedantibiotics and toevaluate the final visual outcomes after therapeutic management. The 397 clinical specimens collected from the infected patients were processed forbacteriological analysis and theantibiogramof the isolates.After specific therapeuticmanagement of these patients, final visual outcomes were evaluated. Results: The isolation of various types of organisms from Bacterial keratitis and Endophthalmitis samples included species of Staphylococci, Streptococci, Diptheroids, Bacillus, Enterococci, Clostridia, Diplococcoids, Pseudomonas, Proteus, Serratia, Haemophilus, Enterobacter, Klebsiella, and yeast and fungi.All isolates were resistant to Cephalosporins, Tobramycin, Gentamycin, andAmikacin. These isolates showed resistance to other drugs such as 80.0% to Chloramphenicol, 73.3%were resistant to Ciprofloxacin, 66.7% to Augmentin, 53.3% to Meropenem, 46.7% to Moxifloxacin, 40% to Sparfloxacin, 40% to Fucidin, and 13.3% to Vancocin. However, all the isolates were found sensitive to Linezolid.During the study, the most commonly used empirical combinations for intravitreal administration were vancomycin and ceftazidime or vancomycin and amikacin. The present study also reported vancomycin, amikacinandceftazidimeas the least resistant antibiotics. Conclusion: The emergence of various bacterial strains resistant to commonly used antibiotics indicates the irrational use of antibiotics in medical practice and the community. The poor visual outcomes of Bacterial keratitis and Endophthalmitis were ascribed to several other factors besides antibiotic resistance.