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Microbiological Study of Bronchoalveolar Lavage in Severe Pneumonia

Sravan Kumar T.* , Sravan Kumar T.* , Aravind* , Pranam G.M.** , Usha Pranam*** , G.A. Manjunath****

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Indian Journal of Trauma and Emergency Pediatrics 8(3):p 195-197, Sept - Dec 2016. | DOI: DOI: http://dx.doi.org/10.21088/ijtep.2348.9987.8316.2

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Abstract

 Aim: To assess the microbiological profile of respiratory tract secretions obtained by BAL of patients admitted to PICU in NMCH&RC with severe pneumonia. Methods: The patients admitted in PICU of NMCH&RC, Raichur, with severe pneumonia in the age group of 1 month ­5 years were evaluated and started on first line of respiratory antibiotics after obtaining samples for relevant investigations, treatment was started as per the respiratory protocol. Among them who failed to respond for the same within 48­72 hours were subjected to BAL. During the period of October­2015 to March­2016 a total of 36 cases underwent BAL. The secretions collected through aseptic method were subjected to gram staining, ZN staining, culture and sensitivity. Results: Bacteriological study of the above 36 patients showed­ No. of cases 1) Gram positive organisms 39% (14) 2) Gram negative organisms 22% ( 8) 3) Fungi 14% ( 5) 4) Pseudomonas 11% ( 4) 5) Acino bacter baumannii 2% ( 1) 6) No yield 11% ( 4) Out 36 cases 26 were ventilated. Out of which Gram positive is more predominant than gram negative. In that 1 was Acino bacter baumannii and 4 were pseudomonas. Remaining 10 cases were managed conservatively. Out which 80% were gram negative and remaining 20% were gram negative. Antibiogram­ Gram positive ­ Linazolide, Amoxiclav Gram negative ­ Meropenem, Amikacin, Colistine Fungi ­ Fluconazole, Amphotericin­B Pseudomonas ­ Colistine + Meropenem Acino bacter baumannii ­ Piperacillin + Tazobactum No yield. Conclusion: The microbiological yield was significantly high (89%). Among that gram positive organisms were high and thus helped in preventing mortality. The yield is good when secretions obtained through BAL. The outcome is good in ventilated patients. Thus we conclude appropriate management of acute severe pneumonia the outcome is excellent.

Keywords: BAL; Antibiogram.

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DOI: DOI: http://dx.doi.org/10.21088/ijtep.2348.9987.8316.2

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