Setting:Medical intensive care units and intensive coronary care units,MCU-FDTMF hispital.
Methodology:Travheal aspirates taken from endotracheal tubes were subjected to a direct gram stain and then followed by moculation of the specimen samples into thtoglycolate media and or blood heart infusion media.These samples were then incubated at 35 degrees centrigrade for 24 hours.After 24 hours turbidity of the solutions were observed.Subcultures on MacKonley,chocolate and blood agar plates were performed form infusions exhibiting turbidity.Gram stain slides were analyzed under oil immersion magnification. Each morphologically distinct microorganism,their gram reaction,morphology and other distinguishing features were qualitatively measured using the plus system.Potential pathogens growing in culture were quantified.
Results:Of the 307 tracheal aspirates 279 were positive for both gram stain and culture,3 of them were positive for culture and 20 were both negative to gram stain and culture.Level of correlation were calculated using the Kappa coefficient and the result was 81 percent suggesting a very good correlation between gram stain and culture.Positive predictive value is 98 percent specifically was 80 percent and the accuracy was 79 percent.
Conclusion:The gram strain of tracheal aspirates highly predicted the possible potential pathogens in culture.This study showed clinicians could use gram stain to institute proper empiric therapy even before they get the final result of the culture.Nosocomial infections is one of the conditions that is very hard to treat.But with effective identification of the pathogen coupled by proper empiric therapy in the earliest time possible may significantly reduce the morbidity and mortality of the patients.
To determine the degree of correlation of Gram stain with culture for the microbiological analysis of tracheal aspirates from patients admitted in medical intensive care units and intensive coronary care units.
To identify the most common isolated pathogens in tracheal aspirates for hospitalized patients clinically manifesting symptoms of nosocomial infections.
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