Microbiology Department, Hermanos Ameijeiras Hospital, Havana, Cuba.
Braz J Infect Dis. 2012 Sep-Oct;16(5):442-7. doi: 10.1016/j.bjid.2012.08.005. Epub 2012 Sep 10.
To characterize mechanical ventilation-associated pneumonia (MVAP).
This is an observational descriptive study to characterize MVAP in 61 ventilated patients admitted in the intensive care units of the Hermanos Ameijeiras hospital during 2011. This study also aimed to isolate the bacteria causing MVAP and characterize their resistance to antibiotics.
51 (83.60%) patients presented pulmonary infiltrates and 35 (50.81%) presented a clinical score ≥ 6 according to the Clinical Pulmonary Infection Score. Acinetobacter baumannii and Pseudomonas aeruginosa were the most frequently isolated microorganisms from patients with MVAP. Both microorganisms showed a high resistance to antibiotics. Carbapenems were the most frequent used antimicrobial therapeutic agents; elective antibiotic combinations were directed against both bacterial wall structure and nucleic acid synthesis.
Patients with MVAP identified during the studied period showed similar frequency to those reported in medical literature. Thus, this study corroborated that this is still a relevant medical problem in this hospital. Acinetobacter baumannii and Pseudomonas aeruginosa were the most frequently isolated microorganisms from patients with MVAP. Antimicrobial treatment, empirical or not, are still the main risk factors for the development of multidrug-resistant strains of bacteria. The rate of resistance to antibiotics of Acinetobacter baumannii and Pseudomonas aeruginosa strains isolated from patients with MVAP was higher than those isolated from infected patients without MAVP. Tigecycline and colistin were the only antibiotics fully effective against Acinetobacter baumannii strains isolated in 2011 from patients with MVAP; against Pseudomonas aeruginosa strains, only colistin was fully effective.
描述机械通气相关性肺炎（MVAP）的特征。
这是一项观察性描述性研究，旨在描述 2011 年期间入住 Hermanos Ameijeiras 医院重症监护病房的 61 例接受机械通气的患者的 MVAP。该研究还旨在分离导致 MVAP 的细菌并对其抗生素耐药性进行特征分析。
51（83.60%）例患者出现肺部浸润，35（50.81%）例患者临床评分≥6 分（根据临床肺部感染评分）。MVAP 患者最常分离到的微生物是鲍曼不动杆菌和铜绿假单胞菌。两种微生物对抗生素均表现出高度耐药性。碳青霉烯类是最常使用的抗菌治疗药物；经验性抗生素联合治疗针对细菌细胞壁结构和核酸合成。
在研究期间鉴定的 MVAP 患者的频率与文献报道的相似。因此，本研究证实这在该医院仍是一个相关的医学问题。MVAP 患者最常分离到的微生物是鲍曼不动杆菌和铜绿假单胞菌。抗生素治疗，无论是经验性还是非经验性，仍然是导致多重耐药细菌菌株发展的主要危险因素。从 MVAP 患者中分离到的鲍曼不动杆菌和铜绿假单胞菌的抗生素耐药率高于从无 MVAP 的感染患者中分离到的这些菌株。替加环素和黏菌素是 2011 年从 MVAP 患者中分离到的鲍曼不动杆菌菌株唯一完全有效的抗生素；对铜绿假单胞菌菌株，只有黏菌素完全有效。
