Department of Medical Diagnostics, Military Institute of Medicine, Warsaw, Poland.
Adv Exp Med Biol. 2015;835:37-44. doi: 10.1007/5584_2014_23.
Lower respiratory tract infections (LRTI) account for 20-30 % of all hospital-acquired contagions. They are characterized by high mortality of hospitalized patients. The most serious form of LRTI is pneumonia, and the most common etiological factors in such cases are bacteria. The article gives the analysis of bacterial flora samples obtained from lower respiratory tract of hospitalized patients. In vitro susceptibility of pathogens to selected antibiotics has also been assessed. We carried out a retrospective analysis of 1,171 bacterial strains isolated from 1,171 patients treated in clinics of the Military Institute of Medicine in Warsaw, Poland. In most cases the samples were collected from an endotracheal or tracheostomic tube (71.5 %) and from bronchoalveolar lavage (21.7 %). The most commonly isolated pathogens included Acinetobacter baumannii (35.8 %), Staphylococcus aureus (27.6 %), Klebsiella pneumoniae (19.4 %), and Pseudomonas aeruginosa (16.2 %). Multidrug-resistant gram-negative bacteria exhibited 100 % susceptibility to colistin only. Klebsiella pneumoniae ESBL+ and Acinetobacter baumannii were most susceptible to carbapenems, while Pseudomonas aeruginosa strains to ceftazidime. Methicillin-resistant Staphylococcus aureus were 100 % susceptible to vancomycin, linezolid, and tigecycline. In conclusion, identifying the etiological factors causing infections of the lower respiratory tract and determining their drug-susceptibility is of key importance in empirical treatment.
下呼吸道感染（LRTI）占所有医院获得性传染病的 20-30％。它们的特点是住院患者死亡率高。LRTI 最严重的形式是肺炎，此类情况下最常见的病因因素是细菌。本文分析了从住院患者下呼吸道获得的细菌菌群样本。还评估了病原体对选定抗生素的体外敏感性。我们对波兰华沙军事医学研究所诊所治疗的 1171 名患者的 1171 株细菌进行了回顾性分析。在大多数情况下，样本是从气管内或气管造口管（71.5％）和支气管肺泡灌洗（21.7％）中收集的。最常分离的病原体包括鲍曼不动杆菌（35.8％），金黄色葡萄球菌（27.6％），肺炎克雷伯菌（19.4％）和铜绿假单胞菌（16.2％）。耐多药革兰氏阴性菌仅对粘菌素表现出 100％的敏感性。产超广谱β-内酰胺酶的肺炎克雷伯菌和鲍曼不动杆菌对碳青霉烯类最敏感，而铜绿假单胞菌对头孢他啶最敏感。耐甲氧西林金黄色葡萄球菌对万古霉素、利奈唑胺和替加环素 100％敏感。总之，确定引起下呼吸道感染的病因因素及其药物敏感性对于经验性治疗至关重要。
