Antibiotic Sensitivity Pattern of Gram Negative Bacilli Isolated from the Lower Respiratory Tract of Ventilated Patients in the Intensive Care Unit.

The causative organisms vary according to the patients’ demographics in the ICU, methods of diagnosis, the durations of hospital and ICU stay. It is necessary to study different etiological organisms and their antimicrobial susceptibility pattern for generating local antibiotic policy. Aims: To study the causative organisms and determine the antibiotic susceptibility pattern of the lower respiratory tract isolates from patients admitted to ICU. Methods and Material: Endotracheal aspirates from 200 patients admitted to the ICU were cultured, identified and antimicrobial susceptibility testing was performed by standard methods. Results: From 200 specimens, 69(34.5%) were culture positive. Total 96 isolates were recovered, from these 92 (96.87%) isolates were gram negative bacilli (GNB). In 34.78% specimens, two isolates were recovered. The most common Gram- negative organism being Acinetobacter spp. (31.25%) followed by Klebsiella spp. (21.87%), E-coli (21.87%) and Pseudomonas Spp. (17.7%). All GNBs were 100% sensitive to polymyxin B and colistin and resistant to piperacillin, ceftazidime and cotrimoxazole. 50% E-coli and 38% of Klebsiella pneumoniae strains were ESBL (extendedspectrum b-lactamase) producers. Conclusions: This study demonstrates the trend in antimicrobial susceptibility pattern of gram negative bacilli in intensive care unit. It is the most important for specific treatment of ventilator associated pneumonia patients and to generate local data periodically to decide empiric antimicrobial therapy.

Breast Fine Needle Aspiration Cytology Reporting : A Study of Application of Probabilistic Approach.

Background: This study is based on application of probabilistic approach in reporting of breast fine needle aspiration cytology, its accuracy and correlation with likelihood of carcinoma in histology. Material and Method: Breast cytology was reported according to 1 of 6 categories, positive, suspicious, atypical, proliferative without atypia, unremarkable and unsatisfactory. Histologic correlation was done whenever possible. Results: Out of total 515 cases, 138 were correlated in histology. There were no false positive cases. The probability of finding carcinoma on histology, for suspicious and atypical categories was 94.11% and 75% respectively. All lesions from proliferative without atypia and unremarkable categories were benign on histology. Conclusion: The probabilistic approach is uniform, accurate method and easy to apply in reporting of breast FNAs. Suspicious and atypical categories were associated with increased incidence of carcinoma in histology and therefore such cases should be further evaluated for histology.