Frequency and Patterns of Multidrug-Resistant Organisms among Ventilated Patients During the Coronavirus Disease-19 Pandemic.

Objective: To determine the frequency of multidrug-resistant (MDR) bacterial isolates in respiratory specimens obtained from ventilated patients admitted to critical care units at the National Institute of Cardiovascular Diseases (NICVD), along with COVID-19-positive cases.

Study Design: An observational study. Place and Duration of the Study: National Institute of Cardiovascular Diseases, between November 2021 and March 2022.

Methodology: Tracheal aspirate and bronchoalveolar lavage (BAL) samples received for culture and sensitivity were obtained from the critical and surgical intensive care units during the specified period. The prevalence of MDR organisms was compared between gram-negative and gram-positive bacteria using the chi-square test to determine any statistical significant differences in their occurrence.

Results: Throughout the study duration, 357 patients were admitted to critical care units, yielding 662 samples of tracheal aspirate and BAL. Among these samples, 229 bacterial isolates were identified, comprising 171 gram-negative rods (GNR) and 58 gram-positive cocci (GPC). The overall prevalence of MDR was determined to be 22% in GNR and 38% in GPC. Additionally, the prevalence of MDR among COVID-19 patients was observed to be approximately 11%.

Conclusion: There was a notable frequency of MDR bacterial isolates in ventilated patients, particularly among GPC strains. Furthermore, the identified prevalence of MDR bacterial isolates in COVID-19 patients underscores the imperative for vigilant monitoring and intervention to address antibiotic resistance in this susceptible cohort.

Key Words: Ventilator-associated pneumonia, Bronchoalveolar lavage, Multidrug-resistant, Gram-negative rods, Gram-positive cocci, Coronavirus disease, Tracheal aspirate.