Brotfain Evgeni, Borer Abraham, Saidel-Odes Lisa, Koyfman Leonid, Frenkel Amit, Smolikov Alexander, Gruenbaum Shaun E, Zlotnik Alexander, Klein Moti
Ben-Gurion University of the Negev Department of Anesthesiology and Critical Care, General Intensive Care Unit, Soroka Medical Center Beer Sheva Israel.
Ben-Gurion University of the Negev Department of Infectious Disease, Soroka Medical Center Beer Sheva Israel.
J Acute Med. 2017 Mar 1;7(1):24-30. doi: 10.6705/j.jacme.2017.0701.004.
Percutaneous bedside tracheostomy (PBT) is a frequently done procedure in the intensive care unit (ICU). The rate of infectious complications and efficacy of perioperative therapy in reducing infections after PBT is currently unknown.
All demographic, clinical and microbiologic data was retrospectively collected from 110 cases of PBT performed in our ICU from 2006 to 2012. Of these patients, 82 patients received perioperative antibiotic therapy (Group 1, "antibiotic group") and 28 did not receive antibiotics (Group 2, "Non antibiotic group").
Patients who received antibiotic therapy had a lower incidence of new ventilator associated pneumonia (VAP) episodes [18% vs. 50 %, = 0.001 (0.23, 0.87-0.13)]. There were no differences in the incidence of bacteremia or line sepsis. Overall Gram negative, Gram positive and fungal flora was similar in both groups before and after PBT.
Our findings highlight the importance of conducting a prospective randomized control trial to better understand the role of antibiotic prophylaxis in PBT.
经皮床边气管切开术（PBT）是重症监护病房（ICU）中经常实施的一项操作。目前，PBT术后感染并发症的发生率以及围手术期治疗在降低感染方面的疗效尚不清楚。
回顾性收集了2006年至2012年在我们ICU进行的110例PBT患者的所有人口统计学、临床和微生物学数据。其中，82例患者接受了围手术期抗生素治疗（第1组，“抗生素组”），28例未接受抗生素治疗（第2组，“非抗生素组”）。
接受抗生素治疗的患者新发呼吸机相关性肺炎（VAP）的发生率较低[18%对50%，P = 0.001（0.23，0.87 - 0.13）]。菌血症或导管相关脓毒症的发生率没有差异。PBT前后两组的总体革兰氏阴性菌、革兰氏阳性菌和真菌菌群相似。
我们的研究结果凸显了开展前瞻性随机对照试验以更好地了解抗生素预防在PBT中的作用的重要性。
