Mohapatra Smrutisree, Pathi Basanti Kumari, Mohapatra Ipsa, Singh Nipa, Sahoo Jyoti Prakash, Das Narendra Kumar, Pattnaik Dipti
Microbiology, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Cureus. 2024 Nov 21;16(11):e74150. doi: 10.7759/cureus.74150. eCollection 2024 Nov.
Stroke-associated pneumonia (SAP) is the aftermath of aspiration of oropharyngeal secretions or stomach content. Mechanical ventilation and lowered immunity and consciousness facilitate the etiopathogenesis of SAP. Antibiotic prophylaxis and repeated culture and sensitivity testing dampen the drug susceptibility patterns of the pathogens. We accomplished this study to determine the bacteriological profile of patients with SAP and the antimicrobial susceptibility patterns of the pathogenic bacteria.
This cross-sectional study was executed from August 2022 to May 2024 at Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, India. We included adult patients who endured treatment in the neurosurgery intensive care unit (ICU) throughout the study period due to a stroke and developed pneumonia within 48 hours of admission. The endotracheal tube (ET) aspirate and bronchoalveolar lavage (BAL) fluid specimens collected from the eligible participants were analyzed. Enriched and selective media such as 5% sheep blood agar, chocolate agar, and MacConkey agar were used to culture pathogenic bacteria. The VITEK 2 system was used to identify isolates and assess antimicrobial susceptibility testing (AST). The pathogenic bacteria and their antimicrobial susceptibility patterns were gauged. We leveraged R software (version 4.4.1) for data analysis.
Two hundred forty bacterial isolates were found in the 181 eligible patients. Forty-eight (26.52%) participants were females. The median age of the study population was 64.50 (58.74-70.24) years. Fifty-nine (32.60%) participants had two different isolates in their culture reports. We found the following non-fermenters: (55, 22.92%), (31, 12.92%), (6, 2.50%), and (4, 1.67%). (88, 36.67%) and (15, 6.25%) were the most commonly noticed Enterobacterales. Other Enterobacterales were (9, 3.75%), (8, 3.33%), (3, 1.25%), (1, 0.42%), (1, 0.42%), and complex (5, 2.08%). (14, 5.83%) was the only gram-positive cocci in our study population. The sensitivity of was maximum for minocycline. was highly sensitive to imipenem and completely resistant to tigecycline. Minocycline was the only effective drug against . Similarly, the Enterobacterales had the greatest sensitivity for tigecycline. All 14 specimens of were sensitive to both vancomycin and linezolid. They were responsive to tigecycline as well.
The most common pathogenic bacteria in our study were , , , , and . Enterobacterales were highly sensitive to tigecycline. and had maximum sensitivity for minocycline. All isolates of were sensitive to both vancomycin and linezolid. We warrant further research with a larger sample size to investigate the bacteriological profile among other critically ill patients and their AST findings.
卒中相关性肺炎（SAP）是口咽分泌物或胃内容物误吸的后果。机械通气以及免疫力和意识降低促进了SAP的发病机制。抗生素预防以及反复的培养和药敏试验会影响病原体的药敏模式。我们开展这项研究以确定SAP患者的细菌学特征以及病原菌的抗菌药敏模式。
这项横断面研究于2022年8月至2024年5月在印度布巴内斯瓦尔的加林加医学科学研究所（KIMS）进行。我们纳入了在整个研究期间因卒中在神经外科重症监护病房（ICU）接受治疗且在入院后48小时内发生肺炎的成年患者。对从符合条件的参与者收集的气管内导管（ET）吸出物和支气管肺泡灌洗（BAL）液标本进行分析。使用5%羊血琼脂、巧克力琼脂和麦康凯琼脂等富集和选择性培养基培养病原菌。采用VITEK 2系统鉴定分离株并评估抗菌药敏试验（AST）。评估病原菌及其抗菌药敏模式。我们利用R软件（版本4.4.1）进行数据分析。
在181名符合条件的患者中发现了240株细菌分离株。48名（26.52%）参与者为女性。研究人群的中位年龄为64.50（58.74 - 70.24）岁。59名（32.60%）参与者在其培养报告中有两种不同的分离株。我们发现了以下非发酵菌：（55株，22.92%），（31株，12.92%），（6株，2.50%），以及（4株，1.67%）。（88株，36.67%）和（15株，6.25%）是最常见的肠杆菌科细菌。其他肠杆菌科细菌有（9株，3.75%），（8株，3.33%），（3株，1.25%），（1株，0.42%），（1株，0.42%），以及复合体（5株，2.08%）。（14株，5.83%）是我们研究人群中唯一的革兰氏阳性球菌。对米诺环素的敏感性最高。对亚胺培南高度敏感，对替加环素完全耐药。米诺环素是针对的唯一有效药物。同样，肠杆菌科细菌对替加环素的敏感性最高。所有14株的标本对万古霉素和利奈唑胺均敏感。它们对替加环素也有反应。
我们研究中最常见的病原菌是、、、、和。肠杆菌科细菌对替加环素高度敏感。和对米诺环素的敏感性最高。所有分离株对万古霉素和利奈唑胺均敏感。我们需要进行更大样本量的进一步研究，以调查其他重症患者的细菌学特征及其AST结果。
