MICROBIOLOGICAL ANALYSIS OF PLEURAL FLUIDS: A STUDY FROM DR.RAJENDRA PRASAD GOVERNMENT MEDICAL COLLEGE , KANGRA AT TANDA(HIMACHAL PRADESH, INDIA)

Introduction:The microbial aetiology of pleural space infections has changed since the introduction of antibiotics. The present study was carried out in department of Microbiology, Dr. Rajendra Prasad Medical College, Kangra at Tanda, Himachal Pradesh, Indiafrom 1^st January 2017 to September 2017 with aim to get the microbiological profile of patients presenting with pleural effusion and empyema.

Methods:The pleural fluid samples collected aseptically by thoracocentesis from inpatients department of medicine, paediatrics and pulmonary medicine departments were included in this study. The specimens were processed for identification based on standard laboratory techniques followed byantibiotic susceptibility testing of the pyogenic isolates performed by Modified Kirby-Bauer disc diffusion technique using Mueller-Hinton agar according to Clinical and Laboratory Standards Institute guidelines.

Results: Over a period of 9 months 45 pleural fluid samples were received. Out of 45 pleural fluid samples only 13(28.8%) gave positivity on bacteriological culture and 5 were positive for mycobacterium tuberculosis by CB-NAAT(Cartridge Based Nucleic Acid Amplification Test).Gram stain positivity was 16.2%.Culture positivity was 28.8%.The most common microorganisms isolated were gram positive organisms and all were identified as Staphylococcus aureus except one isolate each of of coagulase negative Staphylococcus species and             Streptococcus pneumoniae. Among gram negative organisms Proidentiaspp, Ecsherichia coli,Nonfermentor group of organism and Pseudomonas spp. were isolated..The most common antibiotic to which gram positive microorganisms were resistant was Azithromycin(71.4%) followed by Penicillin (57.1%).The gram negative isolates were sensitive to Gentamycin and Imepenem only.

Conclusion: The emergence of antibiotic resistant microorganisms ,the increase in the frequency of nosocomial  infections, and the steadily increasing number of patients with a compromised immunity have combined to keep pleural  infections a common entity