title: Microbiological profile of lower respiratory tract infections in neurological intensive care unit of a tertiary care center from Central India.
abstract: BACKGROUND
  Lower respiratory tract infections (LRTI's) are the most frequent infections among patients in intensive care units. The consequences of increased drug resistance are far reaching since bacterial infection of the lower respiratory tract (LRT) is a major cause of death from infectious disease.
  
  
  OBJECTIVE
  The study was conducted with the aim of determining the bacterial etiology of LRTI in the neuro intensive care unit (NICU) as well as to update the clinicians with the various antimicrobial alternatives available in the treatment of LRTI.
  
  
  METHODS
  The study was conducted for the period of 3 years from January 2010 to December 2012 in the Microbiology Department of a Teaching Tertiary Care Hospital. The LRT specimens from 230 patients admitted in a NICU during the study period were processed. Following culture, the isolated organisms were identified and antimicrobial sensitivity was performed by standard methods.
  
  
  RESULTS
  Out of the 230 LRT specimens evaluated, 198 (86.08%) were culture positive. A total of 254 pathogens were recovered with a predominance of Gram-negative isolates (n = 243; 96.05%) Pseudomonas aeruginosa was the most dominant pathogen followed by Klebsiella pneumoniae. Alarmingly high percentage of extended spectrum beta-lactamase and methicillin resistant Staphylococcus aureus isolates were detected. The resistance to cephalosporins, aminoglycosides and carbapenem were remarkable.
  
  
  CONCLUSIONS
  Therefore, we can conclude that for effective management of LRTI's, an ultimate and detailed bacteriological diagnosis and susceptible testing is required to overcome global problem of antibiotic resistance.
authors.affiliation: Department of Microbiology, Sri Aurobindo Institute of Medical Sciences Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India.
authors.forename: Trupti
authors.initials: T
authors.lastname: Bajpai
authors.affiliation: Department of Microbiology, Sri Aurobindo Institute of Medical Sciences Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India.
authors.forename: G
authors.initials: G
authors.lastname: Shrivastava
authors.affiliation: Department of Microbiology, Sri Aurobindo Institute of Medical Sciences Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India.
authors.forename: G S
authors.initials: GS
authors.lastname: Bhatambare
authors.affiliation: Department of Microbiology, Sri Aurobindo Institute of Medical Sciences Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India.
authors.forename: A B
authors.initials: AB
authors.lastname: Deshmukh
authors.affiliation: Department of Microbiology, Sri Aurobindo Institute of Medical Sciences Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India.
authors.forename: V
authors.initials: V
authors.lastname: Chitnis
keywords: Extended spectrum beta-lactamase; lower respiratory tract infections; methicillin resistant Staphylococcus aureus