Usman Ahmad Kamboh, Rai Gull Fraz, Aqsa Mughal, Mehwish Manzoor, Manzoor Ahmed.
The impact of micro-organism growth on tracheal cultures on duration of ICU stay in a closed neuro-critical care unit in a tertiary care hospital.
J Allama Iqbal Med Coll Jan ;19(4):873-7.

Background: Road traffic accidents are one of the leading causes of morbidity and mortality worldwide. Victims are mostly young and they are in economically productive years of life. Most of them need intensive care unit admissions. Severe traumatic brain injury is a major trauma entity among these patients. In order to combat VAP, intensivists routinely use broad spectrum antibiotics which leads to another health catastrophe in the form of multi-drug resistant microorganisms causing the pneumonia. Methods: We conducted a prospective study from 1st of July, 2020 to 31st of December 2020 in NCCU of Jinnah Hospital, Lahore. The patients who met the inclusion criteria were enrolled in the study after informed consent from the relatives. Results: A total of 70 patients were included in the study. The microbial growth obtained from tracheal swabs of these patients showed Acinetobacter as the most common organism isolated from 27 patients (39%). Acinetobacter had a mortality of 47% (13 out of 27), preceded only by cultures showing no growth causing 80% mortality with an incidence of 14% (10). Although, less common organisms [4% (3)] had 0 mortality. Best GOSe for all growths turned out to be 8. Conclusion: Gram negative organisms have superseded gram positive organisms in ICU. The virulence of Acinetobacter is alarmingly high in severe traumatic brain injury patients in NCCU and the proven fact of high mortality is posing a major threat to the outcome of STBI. Moreover, the outcomes of no growth patients need to be analyzed on individual case basis. Key words: Severe traumatic brain injury (STBI), neuro critical care unit(NCCU)

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