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重症监护病房中的口腔定植:危险因素、发生率、分子流行病学、与肺炎和脓毒症发生的关联以及感染控制措施。

Oral colonization of in intensive care units: Risk factors, incidence, molecular epidemiology, association with the occur of pneumonia and sepsis, and infection control measures.

作者信息

Duman Yucel, Ersoy Yasemin, Tanriverdi Elif Seren, Otlu Barıs, Toplu Sibel Altunisik, Gözükara Bağ Harika Gözde, Tekerekoglu Mehmet Sait, Bulam Nazire, Canturk Elif Kaplan, Parmaksiz Nalan

机构信息

Medical Microbiology Department. Inonu University Medical Faculty, Malatya, Turkey.

Infection Disease Department. Inonu University Medical Faculty, Malatya, Turkey.

出版信息

Iran J Basic Med Sci. 2022 Feb;25(2):239-244. doi: 10.22038/IJBMS.2022.59713.13243.

Abstract

OBJECTIVES

Oral colonization of can lead to infections such as pneumonia and sepsis. We aimed to evaluate oral colonization of hospitalized patients in ICUs and to examine risk factors for oral colonization, molecular epidemiology, and incidence of pneumonia and sepsis.

MATERIALS AND METHODS

The study began in February 2021. Oral cultures were taken. The microorganisms were identified by a Maldi-tof MS mass spectrometry device. Colistin resistance genes were investigated by polymerase chain reaction. Clonal relationships were determined by pulsed-field gel electrophoresis.

RESULTS

was found in 21 of 96 patients' oral cultures. Pneumonia and sepsis due to were detected in 14 and 5 patients, respectively. The mean growth time of from oral cultures was 11.8 days, and the meantime for the occurrence of pneumonia after oral growth was 5.2 days. We determined a plasmid mediated mcr-2 colistin resistance gene in a colistin susceptible strain. It is the first report of the plasmid mediated mcr-2 colistin resistance gene in our country. In total, fourteen different genotypes were determined in PFGE. It was determined that the effects of antibiotic use, oral motor dysfunction, mechanical ventilation, intubation, orogastric tube use, and total parenteral nutrition intake on oral colonization were statistically significant.

CONCLUSION

Oral colonization of is a significant concern in ICUs. We believe that it is important to take oral cultures and follow the risk factors and take infection control measures to prevent oral colonization of resistant isolates in ICUs.

摘要

目的

[某种细菌]的口腔定植可导致肺炎和败血症等感染。我们旨在评估重症监护病房(ICU)住院患者的口腔定植情况,并研究口腔定植的危险因素、分子流行病学以及肺炎和败血症的发病率。

材料与方法

该研究于2021年2月开始。采集口腔培养物。通过基质辅助激光解吸电离飞行时间质谱仪鉴定微生物。通过聚合酶链反应研究黏菌素耐药基因。通过脉冲场凝胶电泳确定克隆关系。

结果

在96例患者的口腔培养物中,有21例检测到[某种细菌]。分别在14例和5例患者中检测到由[某种细菌]引起的肺炎和败血症。口腔培养物中[某种细菌]的平均生长时间为11.8天,口腔生长后肺炎发生的平均时间为5.2天。我们在一株对黏菌素敏感的[某种细菌]菌株中确定了一种质粒介导的mcr - 2黏菌素耐药基因。这是我国关于质粒介导的mcr - 2黏菌素耐药基因的首次报道。通过脉冲场凝胶电泳总共确定了14种不同的[某种细菌]基因型。确定抗生素使用、口腔运动功能障碍、机械通气、插管、鼻胃管使用和全胃肠外营养摄入对口腔定植的影响具有统计学意义。

结论

[某种细菌]的口腔定植是ICU中的一个重要问题。我们认为,在ICU中进行口腔培养并关注危险因素以及采取感染控制措施以预防耐药菌株的口腔定植非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d7/9124532/007de39f52fa/IJBMS-25-239-g001.jpg

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