Guiding Antimicrobial Therapy using Gram Stain in Patients with Ventilator Associated Pneumonia- An Effective Preliminary Diagnostic Tool
Introduction: Empirical antimicrobial therapy is the mainstay of antimicrobial stewardship. The gram stain can be used to guide initial empiric antimicrobial therapy in cases where culture report is not available. This rapid test can therefore be helpful in preventing the initiation of inappropr...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2021-08-01
|
Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://jcdr.net/articles/PDF/15287/49782_F[IK]_GC(AnK)_PF1(AG_SH_KM)_PN(KM).pdf |
id |
doaj-584b58db39d14e16b367c44e1c7195c3 |
---|---|
record_format |
Article |
spelling |
doaj-584b58db39d14e16b367c44e1c7195c32021-10-08T10:51:16ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-08-01158DC16DC1910.7860/JCDR/2021/49782.15287Guiding Antimicrobial Therapy using Gram Stain in Patients with Ventilator Associated Pneumonia- An Effective Preliminary Diagnostic ToolNivedita Thass0 Shweta Singh1Sonal Saxena2Ravinder Kaur3Senior Resident, Department of Microbiology, Lady Hardinge Medical College, New Delhi, India.Postgraduate Student, Department of Microbiology, Lady Hardinge Medical College, New Delhi, IndiaDirector Professor and Head, Department of Microbiology, Maulana Azad Medical College, New Delhi, India.Director Professor and Head, Department of Microbiology, Lady Hardinge Medical College, New Delhi, India. PLAGIARISM CHECKINGIntroduction: Empirical antimicrobial therapy is the mainstay of antimicrobial stewardship. The gram stain can be used to guide initial empiric antimicrobial therapy in cases where culture report is not available. This rapid test can therefore be helpful in preventing the initiation of inappropriate therapy and its adverse outcomes. Aim: To determine the effectiveness of gram stain of tracheal aspirate samples in order to predict the causative microorganism and starting appropriate initial antimicrobial therapy. Materials and Methods: This cross-sectional study was done for 208 tracheal aspirate samples that were sent to Department of Microbiology, Lady Hardinge Medical College, New Delhi, India, with a request for bacterial culture and Antibiotic Susceptibility Testing (AST) from January 2019 to June 2019. Each sample was inoculated on 5% Sheep blood agar, Chocolate agar and MacConkey agar followed by gram stain preparation and smears. The culture plates were checked after 24 hours for any bacterial growth and further identification was done by gram stain, motility and biochemical tests. The AST was performed as per Clinical and Laboratory Standards Institute (CLSI) 2019 guidelines. All data entry was done on MS excel software and appropriate statistical tests were applied. Results: Out of total 208 samples significant gram stain findings were seen in 90 cases (43.2%). Out of 208 samples 132 (63.5%) cases grew significant pathogens on culture. Out of these 90 cases, 68 (75.5%) of gram stain finding matched with culture results. The correlation between gram stain and culture was found to be 75.5%. Conclusion: Gram stain is not only a quick and cost-effective method but also easily available in most laboratories and is highly reproducible. Gram stain, a rapid diagnostic tool, can thus be very useful in antimicrobial stewardship especially for the critically ill patients.https://jcdr.net/articles/PDF/15287/49782_F[IK]_GC(AnK)_PF1(AG_SH_KM)_PN(KM).pdfantimicrobial resistanceendotracheal aspiratepoint of care |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nivedita Thass Shweta Singh Sonal Saxena Ravinder Kaur |
spellingShingle |
Nivedita Thass Shweta Singh Sonal Saxena Ravinder Kaur Guiding Antimicrobial Therapy using Gram Stain in Patients with Ventilator Associated Pneumonia- An Effective Preliminary Diagnostic Tool Journal of Clinical and Diagnostic Research antimicrobial resistance endotracheal aspirate point of care |
author_facet |
Nivedita Thass Shweta Singh Sonal Saxena Ravinder Kaur |
author_sort |
Nivedita Thass |
title |
Guiding Antimicrobial Therapy using Gram Stain in Patients with Ventilator Associated Pneumonia- An Effective Preliminary Diagnostic Tool |
title_short |
Guiding Antimicrobial Therapy using Gram Stain in Patients with Ventilator Associated Pneumonia- An Effective Preliminary Diagnostic Tool |
title_full |
Guiding Antimicrobial Therapy using Gram Stain in Patients with Ventilator Associated Pneumonia- An Effective Preliminary Diagnostic Tool |
title_fullStr |
Guiding Antimicrobial Therapy using Gram Stain in Patients with Ventilator Associated Pneumonia- An Effective Preliminary Diagnostic Tool |
title_full_unstemmed |
Guiding Antimicrobial Therapy using Gram Stain in Patients with Ventilator Associated Pneumonia- An Effective Preliminary Diagnostic Tool |
title_sort |
guiding antimicrobial therapy using gram stain in patients with ventilator associated pneumonia- an effective preliminary diagnostic tool |
publisher |
JCDR Research and Publications Private Limited |
series |
Journal of Clinical and Diagnostic Research |
issn |
2249-782X 0973-709X |
publishDate |
2021-08-01 |
description |
Introduction: Empirical antimicrobial therapy is the mainstay
of antimicrobial stewardship. The gram stain can be used
to guide initial empiric antimicrobial therapy in cases where
culture report is not available. This rapid test can therefore be
helpful in preventing the initiation of inappropriate therapy and
its adverse outcomes.
Aim: To determine the effectiveness of gram stain of tracheal
aspirate samples in order to predict the causative microorganism
and starting appropriate initial antimicrobial therapy.
Materials and Methods: This cross-sectional study was done
for 208 tracheal aspirate samples that were sent to Department of
Microbiology, Lady Hardinge Medical College, New Delhi, India,
with a request for bacterial culture and Antibiotic Susceptibility
Testing (AST) from January 2019 to June 2019. Each sample
was inoculated on 5% Sheep blood agar, Chocolate agar
and MacConkey agar followed by gram stain preparation and
smears. The culture plates were checked after 24 hours for any
bacterial growth and further identification was done by gram
stain, motility and biochemical tests. The AST was performed
as per Clinical and Laboratory Standards Institute (CLSI) 2019
guidelines. All data entry was done on MS excel software and
appropriate statistical tests were applied.
Results: Out of total 208 samples significant gram stain findings
were seen in 90 cases (43.2%). Out of 208 samples 132 (63.5%)
cases grew significant pathogens on culture. Out of these 90
cases, 68 (75.5%) of gram stain finding matched with culture
results. The correlation between gram stain and culture was
found to be 75.5%.
Conclusion: Gram stain is not only a quick and cost-effective
method but also easily available in most laboratories and is
highly reproducible. Gram stain, a rapid diagnostic tool, can
thus be very useful in antimicrobial stewardship especially for
the critically ill patients. |
topic |
antimicrobial resistance endotracheal aspirate point of care |
url |
https://jcdr.net/articles/PDF/15287/49782_F[IK]_GC(AnK)_PF1(AG_SH_KM)_PN(KM).pdf |
work_keys_str_mv |
AT niveditathass guidingantimicrobialtherapyusinggramstaininpatientswithventilatorassociatedpneumoniaaneffectivepreliminarydiagnostictool AT shwetasingh guidingantimicrobialtherapyusinggramstaininpatientswithventilatorassociatedpneumoniaaneffectivepreliminarydiagnostictool AT sonalsaxena guidingantimicrobialtherapyusinggramstaininpatientswithventilatorassociatedpneumoniaaneffectivepreliminarydiagnostictool AT ravinderkaur guidingantimicrobialtherapyusinggramstaininpatientswithventilatorassociatedpneumoniaaneffectivepreliminarydiagnostictool |
_version_ |
1716838504383643648 |