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三级护理癌症医院中呼吸机相关性肺炎的微生物学研究

Microbiology of Ventilator-associated Pneumonia in a Tertiary Care Cancer Hospital.

作者信息

Sangale Aarti, Vivek Bhat, Kelkar Rohini, Biswas Sanjay

机构信息

Department of Microbiology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India.

Department of Microbiology, Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Mumbai, Maharashtra, India.

出版信息

Indian J Crit Care Med. 2021 Apr;25(4):421-428. doi: 10.5005/jp-journals-10071-23790.

Abstract

BACKGROUND

Ventilator-associated pneumonia (VAP) is an important cause of healthcare-associated infections, resulting in prolonged hospitalization with increased morbidity and mortality. Knowledge of predominant local pathogens and their antimicrobial susceptibility patterns helps in selection of appropriate initial antibiotic therapy in these critical cases.

AIM AND OBJECTIVE

The aim and objective of this study is to characterize the microbiology and antimicrobial susceptibility patterns of VAP isolates in a tertiary cancer center.

MATERIALS AND METHODS

This is a 4-year qualitative observational study carried out at a tertiary care cancer hospital in Mumbai. All nondirect bronchoalveolar lavage specimens from patients with a clinical suspicion of VAP sent from the critical care unit to the department of microbiology were processed as per standard laboratory procedures. All isolates were identified to species level and an antimicrobial susceptibility testing was performed by the Kirby-Bauer disk diffusion method and/or the VITEK 2 automated identification and susceptibility system, according to Clinical and Laboratory Standards Institute guidelines.

RESULTS

The study comprised 1,074 patients: 710 (66.10%) men and 364 (33.90%) women. A total of 827 bacterial isolates were obtained with 780 (94.32%) gram-negative organisms and 47 (5.68%) gram-positive organisms; of which (38.7%), (17.5%), and (16.6%) were the commonest. Of gram-negative bacilli, multidrug-resistant organisms constituted 87.50% and were susceptible to colistin.

CONCLUSIONS

VAP is associated with pathogens, such as , and in our setting. High rates of resistance to aminoglycosides, β-lactam-β-lactamase inhibitor combinations, and carbapenems were noted.

HOW TO CITE THIS ARTICLE

Sangale A, Bhat V, Kelkar R, Biswas S. Microbiology of Ventilator-associated Pneumonia in a Tertiary Care Cancer Hospital. Indian J Crit Care Med 2021;25(4):421-428.

摘要

背景

呼吸机相关性肺炎(VAP)是医疗相关感染的重要原因,会导致住院时间延长,发病率和死亡率增加。了解主要的当地病原体及其抗菌药敏模式有助于在这些危急病例中选择合适的初始抗生素治疗方案。

目的

本研究的目的是对一家三级癌症中心的VAP分离株的微生物学和抗菌药敏模式进行特征描述。

材料与方法

这是一项在孟买一家三级护理癌症医院进行的为期4年的定性观察研究。所有从重症监护病房送至微生物科、临床怀疑为VAP患者的非直接支气管肺泡灌洗标本均按照标准实验室程序进行处理。所有分离株均鉴定到种水平,并根据临床和实验室标准协会指南,采用 Kirby-Bauer 纸片扩散法和/或VITEK 2自动鉴定及药敏系统进行抗菌药敏试验。

结果

该研究纳入了1074例患者,其中男性710例(66.10%),女性364例(33.90%)。共获得827株细菌分离株,其中革兰阴性菌780株(94.32%),革兰阳性菌47株(5.68%);其中(38.7%)、(17.5%)和(16.6%)是最常见的。在革兰阴性杆菌中,多重耐药菌占87.50%,对黏菌素敏感。

结论

在我们的研究环境中,VAP与诸如、和等病原体有关。对氨基糖苷类、β-内酰胺-β-内酰胺酶抑制剂联合制剂和碳青霉烯类的耐药率较高。

如何引用本文

Sangale A, Bhat V, Kelkar R, Biswas S. 三级护理癌症医院呼吸机相关性肺炎的微生物学研究。《印度重症监护医学杂志》2021年;25(4):421-428。

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