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儿科重症监护患者气管吸出物培养中生长的微生物的抗生素敏感性

Antibiotic Susceptibility of Microorganisms Grown in Tracheal Aspirate Cultures of Pediatric Intensive Care Patients.

作者信息

Orhan Özhan, Yılmaz Kamil, Gözü Pirinççioğlu Ayfer, Solmaz Murat, Karakoç Ferhat

机构信息

Pediatrics, Kızıltepe State Hospital, Mardin, TUR.

Department of Pediatrics, Dicle University Hospital, Diyarbakır, TUR.

出版信息

Cureus. 2022 Jul 17;14(7):e26934. doi: 10.7759/cureus.26934. eCollection 2022 Jul.

Abstract

Background Microorganisms proliferating in the hospital setting cause infections with high morbidity and mortality rates. In intensive care units (ICUs), the rates of antibiotic resistance and microorganisms grown in cultures may vary by time period. Antibiotic sensitivity must be known for a correct empirical treatment approach. This study aimed to investigate the distribution and antibiotic resistance profiles of pathogenic microorganisms isolated from tracheal aspirate samples in the ICU. Methodology This study enrolled 100 tracheostomized patients aged one month to 18 years, regardless of gender, who were followed in the ICU of Dicle University for more than 72 hours. Medical data were retrospectively evaluated from the medical records. Care was taken to collect samples before changing antibiotics. Antibiotherapy was continued until after culture antibiogram results were obtained, or empirical antibiotic therapy was started by giving consideration to the potential source in patients with a suspected infection. Results An analysis of the tracheal aspirate culture samples of the patients showed that (54%), (16%), and (8%) were the most common pathogens. An analysis of the culture antibiogram results of the tracheal aspirate samples obtained from the entire study population showed that was 100% resistant against vancomycin, clindamycin, and teicoplanin, but highly sensitive to colistin and amikacin. was highly resistant to almost all antibiotics but showed no resistance against colistin. Carbapenems being frequently preferred for cases where empirical therapy should be initiated for ICU infections can be one of the reasons for a high carbapenem resistance rate in our hospital. Conclusions We believe that starting empirical therapy with colistin when infections caused by and are suspected may be an appropriate initial therapy until culture antibiogram results become available. Microbiological data are crucial for a correct empirical treatment approach. In this way, intensive antibiotic usage and subsequent high antibiotic resistance can be adequately controlled.

摘要

背景 在医院环境中增殖的微生物会引发感染,其发病率和死亡率很高。在重症监护病房(ICU),抗生素耐药率和培养出的微生物可能随时间段而变化。为了采取正确的经验性治疗方法,必须了解抗生素敏感性。本研究旨在调查从ICU气管吸出物样本中分离出的致病微生物的分布和抗生素耐药谱。方法 本研究纳入了100例年龄在1个月至18岁之间的气管切开患者,不分性别,他们在狄克莱大学ICU接受了超过72小时的随访。从病历中对医疗数据进行回顾性评估。在更换抗生素之前小心收集样本。继续进行抗生素治疗,直到获得培养药敏结果,或者对于疑似感染的患者,考虑潜在来源开始经验性抗生素治疗。结果 对患者的气管吸出物培养样本分析表明,(54%)、(16%)和(8%)是最常见的病原体。对从整个研究人群获得的气管吸出物样本的培养药敏结果分析表明,对万古霉素、克林霉素和替考拉宁的耐药率为100%,但对黏菌素和阿米卡星高度敏感。对几乎所有抗生素都高度耐药,但对黏菌素无耐药性。在ICU感染应开始经验性治疗的情况下,碳青霉烯类药物经常被首选,这可能是我院碳青霉烯类耐药率高的原因之一。结论 我们认为,当怀疑由和引起感染时,开始使用黏菌素进行经验性治疗可能是一种合适的初始治疗方法,直到获得培养药敏结果。微生物学数据对于正确的经验性治疗方法至关重要。通过这种方式,可以充分控制抗生素的大量使用以及随后产生的高抗生素耐药性。

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