三级医院重症监护病房患者气管分泌物分离株的细菌学特征和耐药性

Bhavin Prajapati, P. Gohel, Atit Shah, H. Shah, Kaival K Kothari, Jayshri Pethani
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引用次数: 0

摘要

引言:呼吸道感染与高发病率和死亡率有关,尤其是在危重患者中。广谱抗生素的过度使用导致了耐药性的发展,从而导致了难以治疗的病原体的出现。材料和方法:2019年11月至2020年2月,在一家三级护理医院微生物科细菌科共接收632份气管分泌物。根据标准操作程序处理气管分泌物进行培养。鉴定、表型检测和抗生素敏感性测试通过自动化VITEK-2 Compact系统进行。结果:在研究期间,共收到632份气管分泌物,559份培养物产生了显著的病原体,73份培养物中未分离出任何生物体。在革兰氏阴性菌540(97%)中,肺炎克雷伯菌(30%)是最常见的分离株。分离到革兰氏阳性菌12株(2%)和念珠菌7株(1%)。在大肠杆菌和肺炎克雷伯菌中检测到的最常见表型是超广谱β-内酰胺酶产生者。结论:肺炎克雷伯菌是重症监护病房患者中最常见的气管分泌物分离物。大肠杆菌素,其次是替加环素,被发现是最易感的抗生素。肺炎克雷伯菌对替加环素敏感(69%),最低抑制浓度≤1。0.6%。肺炎克雷伯菌对粘菌素具有耐药性。
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Bacteriological Profile and antibiotic susceptibility pattern of tracheal secretions isolates among intensive care unit patients at tertiary care hospital
Introduction: Respiratory infections are associated with high morbidity and mortality, especially in critically ill patients. The excessive use of broad-spectrum antibiotics has led to the development of drug resistance, thus resulting in the emergence of pathogens which are difficult to treat. Materials and Methods: A total of 632 tracheal secretions were received in the Bacteriology section of the microbiology department of a tertiary care hospital from November 2019 to February 2020. Tracheal secretions were processed for culture according to standard operating procedures. Identification, phenotype detection, and antibiotic sensitivity testing were performed by automated VITEK-2 Compact system. Results: In total, 632 tracheal secretions were received during the study period, 559 cultures yielded significant pathogens and no organisms were isolated in 73 cultures. Among the Gram-negative organism 540 (97%), Klebsiella pneumoniae (30%) was the most common isolates. Gram-positive organisms 12 (2%) and Candida spp. 7 (1%) were isolated. The most common phenotype detected in Escherichia coli and K. pneumoniae was extended-spectrum beta-lactamase producer. Conclusions: K. pneumoniae was the most common isolate from tracheal secretion among intensive care unit patients. Colistin, followed by tigecycline, was found to be the most susceptible antibiotics. K. pneumoniae was found to be sensitive to tigecycline (69%) with minimum inhibitory concentrations of ≤ 1. 0.6%. K. pneumoniae was colistin resistant.
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