Gagneja Deep, Goel Nidhi, Aggarwal Ritu, Chaudhary Uma
Department of Microbiology, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India.
Indian J Crit Care Med. 2011 Jul;15(3):164-7. doi: 10.4103/0972-5229.84900.
Lower respiratory tract infections (LRTIs) are the most frequent infections among patients in intensive care units (ICUs).
To track the resistance rate among the causative agents causing LRTI in the ICU patients.
This is a retrospective study done in a tertiary care hospital.
Transtracheal or bronchial aspirates from 2776 patients admitted to the ICU were cultured and identified, and antibiotic sensitivity was performed by standard methods.
Of 2776 specimens, 1233 (44.41%) isolates were recovered, of which 1123 (91.07%) were gram-negative bacilli (GNB) and 110 (8.92%) were gram-positive organisms. From 2004 to 2009, Pseudomonas aeruginosa remained the most common pathogen. In phase I, high level of resistance (79-98%) was observed against all GNB. During phase II increasing trend in resistance to cephalosporins and declining trend in resistance to aminoglycosides against most GNB were observed. Multidrug resistance (resistance to three or more than three drugs) was observed in 83% of total isolates.
Gram-negative organisms are the predominant pathogens causing LRTI in ICU. The increasing trend of resistance to cephalosporins and carbapenems in gram-negative organisms is very disturbing. Judicious use of antimicrobial agents is essential to prevent the emergence of multidrug-resistant bacteria in the ICU.
下呼吸道感染(LRTIs)是重症监护病房(ICUs)患者中最常见的感染。
追踪重症监护病房患者下呼吸道感染病原体的耐药率。
这是一项在三级护理医院进行的回顾性研究。
对入住重症监护病房的2776例患者的经气管或支气管吸出物进行培养和鉴定,并采用标准方法进行药敏试验。
在2776份标本中,分离出1233株(44.41%),其中1123株(91.07%)为革兰氏阴性杆菌(GNB),110株(8.92%)为革兰氏阳性菌。2004年至2009年,铜绿假单胞菌仍是最常见的病原体。在第一阶段,观察到所有革兰氏阴性杆菌的高水平耐药(79-98%)。在第二阶段,观察到大多数革兰氏阴性杆菌对头孢菌素的耐药性呈上升趋势,对氨基糖苷类的耐药性呈下降趋势。在所有分离株中,83%观察到多重耐药(对三种或三种以上药物耐药)。
革兰氏阴性菌是重症监护病房引起下呼吸道感染的主要病原体。革兰氏阴性菌对头孢菌素和碳青霉烯类耐药性的上升趋势非常令人担忧。合理使用抗菌药物对于预防重症监护病房多重耐药菌的出现至关重要。