Disinfection supply center, First Affiliated Hospital of Gannan Medical College, Ganzhou, Jiangxi341000, China..
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Cell Mol Biol (Noisy-le-grand). 2022 Feb 28;68(2):42-47. doi: 10.14715/cmb/2022.68.2.6.
This research aimed to investigate the microbial spectrum of microorganisms that cause ventilator-associated pneumonia (VAP) among ICU patients in the selected hospital, antimicrobial susceptibility, genetic diversity of common isolates, and the monitoring effect of microbial culture on cleaning and sanitizing of external ventilator circuits in order to reduce the occurrence of hospital infections. For this purpose, endotracheal aspirate (ETA) specimens were sampled from ICU patients with clinically suspected VAP in the hospital between August 2020 and August 2021 and then investigated for microbiological content. This was followed by Kirby-Bauer testing for determining drug sensitivity and ERIC-PCR for genotyping. Afterward, microbial culture was performed on cleaned, sanitized and dried ventilator external ventilator pipelines and those stored aseptically for 4 weeks to evaluate the cleaning and disinfection effect and measure the bacterial content. Results showed that in the 64 confirmed VAP cases, Klebsiella was the most frequently isolated organism, followed by P. aeruginosa and Acinetobacter baumannii, while Candida is the most widely isolated fungus. The antimicrobial susceptibility spectrum revealed that 40% of the isolates were multidrug-resistant (MDR). ERIC-PCR showed no genetic relationship between pneumococcal isolates. Through microbial culture, no pathogenic bacteria were detected among cleaned and sanitized ventilator external ventilator pipelines and those stored aseptically for 4 weeks, indicating a 100% pass rate. It was concluded that ventilators in intensive care units (ICU) are susceptible to contamination, exposing patients to bacterial contamination and other comorbidities. Gram-negative bacteria are the main pathogens of VAP, which are mostly multidrug-resistant. Clinical care measures for ventilators should be strengthened to reduce the incidence of ventilator microbial contamination and to improve accurate clinical diagnosis and correct antimicrobial therapy.
本研究旨在调查选定医院 ICU 患者呼吸机相关性肺炎(VAP)相关微生物的微生物谱、抗菌药物敏感性、常见分离株的遗传多样性,以及微生物培养对清洗和消毒外部呼吸机管路的监测效果,以降低医院感染的发生。为此,于 2020 年 8 月至 2021 年 8 月期间,从医院临床疑似 VAP 的 ICU 患者中采集气管内吸出物(ETA)标本进行微生物学内容调查,然后进行 Kirby-Bauer 药敏试验和 ERIC-PCR 进行基因分型。之后,对清洗、消毒和干燥的呼吸机外部呼吸机管路以及无菌保存 4 周的呼吸机外部呼吸机管路进行微生物培养,以评估清洗和消毒效果并测量细菌含量。结果显示,在 64 例确诊的 VAP 病例中,最常分离到的细菌是肺炎克雷伯菌,其次是铜绿假单胞菌和鲍曼不动杆菌,而最广泛分离到的真菌是念珠菌。抗菌药物敏感性谱显示,40%的分离株为多药耐药(MDR)。ERIC-PCR 显示肺炎链球菌分离株之间没有遗传关系。通过微生物培养,在清洗和消毒的呼吸机外部呼吸机管路以及无菌保存 4 周的呼吸机外部呼吸机管路中未检测到致病菌,合格率为 100%。结论:重症监护病房(ICU)中的呼吸机容易受到污染,使患者暴露于细菌污染和其他合并症中。革兰氏阴性菌是 VAP 的主要病原体,大多数是多药耐药菌。应加强对呼吸机的临床护理措施,以降低呼吸机微生物污染的发生率,并提高准确的临床诊断和正确的抗菌治疗。