Bajpai Trupti, Shrivastava G, Bhatambare G S, Deshmukh A B, Chitnis V
Department of Microbiology, Sri Aurobindo Institute of Medical Sciences Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India.
J Basic Clin Pharm. 2013 Jun;4(3):51-5. doi: 10.4103/0976-0105.118789.
Lower respiratory tract infections (LRTI's) are the most frequent infections among patients in intensive care units. The consequences of increased drug resistance are far reaching since bacterial infection of the lower respiratory tract (LRT) is a major cause of death from infectious disease.
The study was conducted with the aim of determining the bacterial etiology of LRTI in the neuro intensive care unit (NICU) as well as to update the clinicians with the various antimicrobial alternatives available in the treatment of LRTI.
The study was conducted for the period of 3 years from January 2010 to December 2012 in the Microbiology Department of a Teaching Tertiary Care Hospital. The LRT specimens from 230 patients admitted in a NICU during the study period were processed. Following culture, the isolated organisms were identified and antimicrobial sensitivity was performed by standard methods.
Out of the 230 LRT specimens evaluated, 198 (86.08%) were culture positive. A total of 254 pathogens were recovered with a predominance of Gram-negative isolates (n = 243; 96.05%) Pseudomonas aeruginosa was the most dominant pathogen followed by Klebsiella pneumoniae. Alarmingly high percentage of extended spectrum beta-lactamase and methicillin resistant Staphylococcus aureus isolates were detected. The resistance to cephalosporins, aminoglycosides and carbapenem were remarkable.
Therefore, we can conclude that for effective management of LRTI's, an ultimate and detailed bacteriological diagnosis and susceptible testing is required to overcome global problem of antibiotic resistance.
下呼吸道感染（LRTI）是重症监护病房患者中最常见的感染。由于下呼吸道（LRT）细菌感染是传染病死亡的主要原因，耐药性增加的后果影响深远。
本研究旨在确定神经重症监护病房（NICU）中LRTI的细菌病因，并向临床医生介绍治疗LRTI时可用的各种抗菌替代药物。
本研究于2010年1月至2012年12月在一家教学三级医院的微生物科进行，为期3年。对研究期间入住NICU的230例患者的LRT标本进行处理。培养后，通过标准方法鉴定分离出的微生物并进行药敏试验。
在评估的230份LRT标本中，198份（86.08%）培养呈阳性。共分离出254种病原体，以革兰氏阴性菌为主（n = 243；96.05%），铜绿假单胞菌是最主要的病原体，其次是肺炎克雷伯菌。检测到超广谱β-内酰胺酶和耐甲氧西林金黄色葡萄球菌分离株的比例高得惊人。对头孢菌素、氨基糖苷类和碳青霉烯类的耐药性显著。
因此，我们可以得出结论，为了有效管理LRTI，需要进行最终的详细细菌学诊断和药敏试验，以克服抗生素耐药性这一全球性问题。
