Saleem Mohd, Syed Khaja Azharuddin Sajid, Hossain Ashfaque, Alenazi Fahaad, Said Kamaleldin B, Moursi Soha Abdallah, Almalaq Homoud Abdulmohsin, Mohamed Hamza, Rakha Ehab, Alharbi Mohammed Salem, Babiker Salma Ahmed Ali, Usman Kauser
Department of Pathology, College of Medicine, University of Hail, Hail, Kingdom of Saudi Arabia.
Department of Medical Microbiology and Immunology, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates.
Infect Drug Resist. 2023 Feb 5;16:769-778. doi: 10.2147/IDR.S394777. eCollection 2023.
Ventilator-associated pneumonia (VAP) is associated with a higher mortality risk for critical patients in the intensive care unit (ICU). Several strategies, including using β-lactam antibiotics, have been employed to prevent VAP in the ICU. However, the lack of a gold-standard method for VAP diagnosis and a rise in antibiotic-resistant microorganisms have posed challenges in managing VAP. The present study is designed to identify, characterize, and perform antimicrobial susceptibility of the microorganisms from different clinical types of infections in ICU patients with emphasis on VAP patients to understand the frequency of the latter, among others.
A 1-year prospective study was carried out on patients in the ICU unit at a tertiary care hospital, Hail, Saudi Arabia.
A total of 591 clinically suspected hospital-acquired infections (HAI) were investigated, and a total of 163 bacterial isolates were obtained from different clinical specimens with a high proportion of bacteria found associated with VAP (70, 43%), followed by CAUTI (39, 24%), CLABSI (25, 15%), and SSI (14, 8.6%). was the most common isolate 39 (24%), followed by 35 (21.5%), 25 (15.3%), and spp 23 (14%). Among the highly prevalent bacterial isolates, extended-spectrum beta-lactamase was predominant 42 (42.4%).
Proper use of antibiotics, continuous monitoring of drug sensitivity patterns, and taking all precautionary measures to prevent beta-lactamase-producing organisms in clinical settings are crucial and significant factors in fending off life-threatening infections for a better outcome.
呼吸机相关性肺炎（VAP）与重症监护病房（ICU）中危重症患者的较高死亡风险相关。包括使用β-内酰胺类抗生素在内的多种策略已被用于预防ICU中的VAP。然而，缺乏VAP诊断的金标准方法以及抗生素耐药微生物的增加给VAP的管理带来了挑战。本研究旨在鉴定、表征ICU患者不同临床感染类型的微生物并进行药敏试验，重点关注VAP患者，以了解后者的发生频率等情况。
在沙特阿拉伯海勒市一家三级医院的ICU对患者进行了为期1年的前瞻性研究。
共调查了591例临床疑似医院获得性感染（HAI），从不同临床标本中总共获得了163株细菌分离株，其中与VAP相关的细菌比例较高（70株，43%），其次是导尿管相关尿路感染（CAUTI，39株，24%）、中心静脉导管相关血流感染（CLABSI，25株，15%）和手术部位感染（SSI，14株，8.6%）。最常见的分离株是[具体菌株1]，共39株（24%），其次是[具体菌株2]，35株（21.5%），[具体菌株3]，25株（15.3%），以及[具体菌属]菌，23株（14%）。在高度流行的细菌分离株中，产超广谱β-内酰胺酶的菌株占主导，共42株（42.4%）。
合理使用抗生素、持续监测药敏模式以及在临床环境中采取一切预防措施以防止产β-内酰胺酶的生物体，是预防危及生命的感染以获得更好预后的关键和重要因素。
