Alqurashi Abdulrahman M
Department of Microbiology, College of Medicine, King Faisal University, Dammam, Saudi Arabia.
J Family Community Med. 2005 Sep;12(3):139-44.
Ventilator associated pneumonia (VAP) is a frequent complication of mechanical ventilation (MV) and it is a leading cause of death in MV patients. The development of VAP has been demonstrated as being due to aspiration of oropharyngeal secretion, ventilator tubing condensate, or gastric contents that are colonized with pathogenic microorganisms. The aim of the present study is to isolate and identify bacteria that cause VAP and to study antibiotic susceptibility.
This study was carried out on 95 patients who fulfilled the diagnostic criteria for VAP. Quantitative cultures of endotracheal aspirates (EA) using a cut-off point of 10(6) cfu/ml was done.
The microbiological results revealed that gram negative bacilli were the most common bacterial agents responsible for VAP and accounted for 78.8% of all the causative agents. The most common isolated organisms were Klebsiella pnemouniae (30.9 %) followed by Pseudomonas aeruginosa (22.5%), Staphylococcus aureus (21.2%), Eschericia coli (12.8 %), Proteus spp. (9.8%), and Citrobacter spp. (2.8%). Blood cultures were positive in 25.9% of patients with Klebsiella pnemouniae in about 33.3%.
From this study, it can be concluded that VAP is an important nosocomial infection. EA is a simple procedure to obtain respiratory samples and perform sensitivity testing in patients with VAP. Also, the commonest cause of VAP is gram negative bacilli.
呼吸机相关性肺炎(VAP)是机械通气(MV)常见的并发症,也是MV患者死亡的主要原因。VAP的发生已证实是由于口咽分泌物、呼吸机管路冷凝水或定植有致病微生物的胃内容物误吸所致。本研究的目的是分离和鉴定引起VAP的细菌,并研究其抗生素敏感性。
本研究对95例符合VAP诊断标准的患者进行。采用10(6) cfu/ml的截断值对气管内吸出物(EA)进行定量培养。
微生物学结果显示,革兰阴性杆菌是引起VAP最常见的细菌病原体,占所有病原体的78.8%。最常见的分离菌是肺炎克雷伯菌(30.9%),其次是铜绿假单胞菌(22.5%)、金黄色葡萄球菌(21.2%)、大肠埃希菌(12.8%)、变形杆菌属(9.8%)和柠檬酸杆菌属(2.8%)。约33.3%的肺炎克雷伯菌感染患者血培养呈阳性,占所有患者的25.9%。
从本研究可以得出结论,VAP是一种重要的医院感染。EA是一种简单的方法,可用于获取VAP患者的呼吸道样本并进行药敏试验。此外,VAP最常见的病因是革兰阴性杆菌。