Evaluation of Microorganisms Causing Ventilator-Associated Pneumonia in a Pediatric Intensive Care Unit
Evaluation of Microorganisms Causing Ventilator-Associated Pneumonia in a Pediatric Intensive Care Unit
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DOI：
10.5152/eurasianjmed.2017.16262
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发表时间：
2017-06-01
影响因子：
1.5
通讯作者：
Torun, Yasemin Altuner
中科院分区：
文献类型：
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作者：
Ergul, Ayse Betul;Cetin, Serife;Torun, Yasemin Altuner
目的：本研究的目的是鉴定引起呼吸机相关性肺炎（VAP）的微生物，并研究其抗生素耐药性/敏感性。材料和方法：我们回顾性评估了2014年1月1日至2016年6月30日期间在儿科重症监护病房诊断为VAP的患者中分离的微生物。其患病率为8.6例患者/1，000个呼吸机日。56.5%的患者需要机械通气。33例患者（75%）死亡。在75%的患者（n=33）中检测到基础慢性疾病。从44例患者中分离出50种微生物。从86.4%（n=38）的患者中分离出单一微生物，从13.6%（n=6）的患者中分离出两种微生物。在所有分离的细菌中，96%（n=48）为革兰氏阴性菌;最常见的是铜绿假单胞菌（32%），其次是肺炎克雷伯菌（24%）和鲍曼不动杆菌（22%）。菌株对粘菌素最敏感（92.6%），其次是哌拉西林-他唑巴坦（71.4%）、阿米卡星（65.2%）和庆大霉素（52.2%）。没有肠杆菌属或不动杆菌属菌株对粘菌素耐药;然而，13%的铜绿假单胞菌菌株耐药。结论：在VAP中，必须对存在于单位中的细菌的抗生素耐药模式进行分类，以确保经验性抗生素治疗是有效的。
Objective: The aim of this study was to identify microorganisms causing ventilator-associated pneumonia (VAP) and also study the antibiotic resistance/susceptibility.Materials and Methods: We retrospectively assessed microorganisms isolated from patients diagnosed with VAP in a pediatric intensive care unit between January 1, 2014, and June 30, 2016.Results: We included 44 patients diagnosed with VAP. The prevalence thereof was 8.6 patients per 1,000 ventilator days. Mechanical ventilation was required for 56.5% of patients. Thirty-three patients (75%) died. An underlying chronic disease was detected in 75% of patients (n=33). Fifty microorganisms were isolated from 44 patients. Single microorganisms were isolated from 86.4% (n=38) and two from 13.6% (n=6) of patients. Of all the isolated bacteria, 96% (n=48) were gram-negative; the most common was Pseudomonas aeruginosa (32%), followed by Klebsiella pneumoniae (24%) and Acinetobacter baumannii (22%). The isolates were most susceptible to colistin (92.6%), followed by piperacillin-tazobactam (71.4%), amikacin (65.2%), and gentamicin (52.2%). No enterobacterium or Acinetobacter strain was resistant to colistin; however, 13% of P. aeruginosa isolates were resistant.Conclusion: In VAP, it is essential to catalog antibiotic resistance patterns of bacteria present in the unit to ensure that empirical antibiotic therapy is effective.