Antimicrobial-resistant Pseudomonas aeruginosa and Acinetobacter baumannii From Patients With Hospital-acquired or Ventilator-associated Pneumonia in Vietnam

2016 ◽  
Vol 38 (9) ◽  
pp. 2098-2105 ◽  
Author(s):  
Douglas J. Biedenbach ◽  
Phan Trong Giao ◽  
Pham Hung Van ◽  
Nguyen Su Minh Tuyet ◽  
Tran Thi Thanh Nga ◽  
...  
2019 ◽  
Vol 72 (5) ◽  
pp. 892-896
Author(s):  
Olha A. Poda ◽  
Tetyana O. Kryuchko ◽  
Inna N. Nesina ◽  
Olha Ya. Tkachenko ◽  
Nataliia V. Kuzmenko

Introduction: Nowadays anti-microbial therapy of ventilator-associated pneumonia caused by is one of the most topical issue as a consequence of widespread multiresistant strains of causative agent and their biological peculiarity of actively formation of resistance to new antibacterial drugs. The aim is to describe modern approaches to therapy of ventilator-associated pneumonia causative agent of which is presented by Pseudomonas aureginosa . Materials and methods: An analysis and summing up of results of scientific investigations described in medical publications concerning the issues of therapy of ventilatorassociated pneumonia caused by Pseudomonas aureginosa was done. Conclusions: Despite the development of modern approaches to anti-microbial therapy of ventilator-associated pneumonia caused by Pseudomonas aeruginosa, which are also concerned with such controversial issues as correct choice of antibacterial drug, its optimal dose, and duration of this therapy, the problem of treatment of hospital-acquired infections of respiratory airways caused by Pseudomonas aeruginosa has been discussable yet and requires the further study.


2016 ◽  
Vol 4 (2) ◽  
pp. 49-55
Author(s):  
ASM Areef Ahsan ◽  
Mohammad Omar Faruq ◽  
Kaniz Fatema ◽  
Fatema Ahmed ◽  
Shakera Binte Hassan

Background and Objectives: For diagnosis of nosocomial pneumonia in patients on ventilator, invasive procedure like bronchoscopy for microscopy and quantitative cultures of lower respiratory tract samples is useful but not always possible for potential risk of the procedure and the associated cost. The non-bronchoscopic sampling of the lower airways and quantitative cultures of tracheal aspirate may offer simple and readily available alternative to bronchoscopy with promising results. This study was done to evaluate the efficacy of blind tracheal aspirate in the microbiological diagnosis of nosocomial pneumonia occurring in intubated patients on mechanical ventilator. Materials & Methods: This cross-sectional study was carried out in the Intensive Care Unit in the Department of Critical Care Medicine, BIRDEM Hospital, Dhaka over a period 16 months starting from January 2010 to April 2011. A total of 54 clinically diagnosed cases of nosocomial (hospital acquired) pneumonia who were on ventilator were consecutively included in the study based on predefined enrolment criteria. All the 54 cases were subjected to blind endotracheal aspirate (BTA) followed by bronchoalveolar lavage (BAL) for quantitative cultures of specimens and isolation of causative microorganisms from them. Result: The present study showed that the mean age of the patients was 61 years (range: 24-86 years). Males were predominant in the series with male to female ratio being 7:3. Majority of the patients was haemodynamically stable as indicated by mean blood pressures, heart rate, temperature and respiratory rate. Most (83.3%) of the cases showed significant growth of microbes on culture of blind tracheal aspirates at cut-off value of 105 colony forming unit/ml (cfu/ml), while 87% of the cases exhibited positive growth on culture of bronchoalveolar lavage at cut-off value of 104 cfu/ml. Acinetobacter baumannii was the predominant organism isolated from BTA (73.3%) followed by Pseudomonas aeruginosa (33.3%). An almost similar pattern of growth was evident in BAL with more than 70% being Acinetobacter baumannii and about 30% Pseudomonas aeruginosa. C. albicans. Kiebsiella sp., E. coli, and Flavobacter were less commonly observed in either group. The Kappa test revealed a good agreement (70.7%) between the two procedures suggesting that the two diagnostic modalities are almost comparable in diagnosing pneumonia in patients admitted in ICU (p < 0.001). Conclusion: The study concluded that the accuracy of blind tracheal aspirate and bronchalveolar lavage in the diagnosis of nosocomial pneumonia was fairly comparable. The strength of agreement between the two diagnostic modalities is also good encouraging its use instead of more invasive procedures like BAL in the diagnosis of hospital-acquired pneumonia who are on mechanical ventilator. Ibrahim Cardiac Med J 2014; 4(2): 49-55


2010 ◽  
Vol 4 (05) ◽  
pp. 282-291 ◽  
Author(s):  
Noyal Mariya Joseph ◽  
Sujatha Sistla ◽  
Tarun Kumar Dutta ◽  
Ashok Shankar Badhe ◽  
Desdemona Rasitha ◽  
...  

Background: Pseudomonas aeruginosa and Acinetobacter baumannii have been reported to cause outbreaks of ventilator-associated pneumonia (VAP) in several studies. The high prevalence of these pathogens prompted us to study the different strains of these pathogens prevailing in our intensive care units (ICUs) and determine the role of ICU environment and health-care workers (HCWs) in the transmission of infection. Methodology: A prospective study was performed over a period of 15 months in two ICUs of Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India. Surveillance samples were collected from the HCWs and the ICU environment. Quantitative antibiogram typing and PCR-RFLP were used for comparison of the isolates from the surveillance samples and VAP patients. Results: Pseudomonas aeruginosa and Acinetobacter baumannii were the most common potential VAP pathogens isolated from the surveillance cultures. Eight strains of Pseudomonas aeruginosa were present in our ICUs, but multi-drug resistant (MDR) strain 2 and strain 4 were the most prevalent strains. Six strains of Acinetobacter baumannii were found in our ICUs, of which MDR strain 1 and strain 3 were the most common. The strains of Pseudomonas aeruginosa and Acinetobacter baumannii observed in the VAP patients were also found in the ICU milieu. Only one HCW was found to be the carrier of a Pseudomonas aeruginosa strain present in a VAP patient. Conclusions: The ICU environment was observed to be the potential reservoir for VAP pathogens; therefore, strict adherence to environmental infection control measures is essential to prevent health-care-associated infections.


Author(s):  
Tram Anh Que

TÓM TẮT Đặt vấn đề: Viêm phổi liên quan thở máy là bệnh lý nhiễm khuẩn bệnh viện rất thường gặp trong đơn vị hồi sức tích cực. Có nhiều vi khuẩn gây viêm phổi liên quan thở máy, trong đó các vi khuẩn Gram âm không lên men như Acinetobacterbaumannii, Pseudomonasaeruginosa,.. là những vi khuẩn gây bệnh hàng đầu và có mức độ kháng kháng sinh cao. Phương pháp: Một nghiên cứu mô tả cắt ngang được thực hiện ở các chủng vi khuẩn Gram âm không lên men phân lập được từ các mẫu đờm của bệnh nhân thở máy trên 48 giờ điều trị tại các khoa Hồi sức tích cực - Ngoại khoa Bệnh viện Hữu nghị Đa khoa Nghệ An năm từ 1/2020 đến 6/2021. Kết quả: Phân lập được 120 chủng Vi khuẩn Gram âm không lên men, trong đó, Acinetobacter baumannii 85 chủng, Pseudomonas aeruginosa 31 chủng. Acinetobacter baumannii có mức độ đề kháng trên 70% với tất cả các kháng sinh thử nghiệm, trong đó kháng cao nhất với Ceftriaxone 96,9%. Pseudomonas aeriginosa kháng với tất cả các kháng sinh thử nghiệm, kháng cao nhất với Gentamycin 80,0%, kháng thấp nhất với Piperacillin/Tazobactam 32,3%. Kết luận: Vi khuẩn không lên men là những tác nhân chính gây viêm phổi liên quan thở máy, phổ biến nhất là Acinetobacter baumannii và Pseudomonas aeruginosa. Những vi khuẩn này kháng cao với các kháng sinh thử nghiệm, trong đó, A. baumannii kháng trên 70% các kháng sinh thử nghiệm, P. aeruginosa kháng tất cả kháng sinh thử nghiệm với mức độ khác nhau tử 32,3 - 80,0%. ABSTRACT ANTIBIOTIC RESISTANCE OF NON - FERMENTABLE GRAM - NEGATIVE BACTERIA CAUSING PNEUMONIA IN PATIENTS WITH MECHANICALLY VENTILATION Background: Ventilator - associated pneumonia is a very common nosocomial infection in the intensive care unit. Many bacteria cause ventilator - associated pneumonia, in which non - fermentative Gram - negative bacteria such as Acinetobacter baumannii, Pseudomonas aeruginosa, etc., are the leading pathogens and have high antibiotic resistance. Methods: A cross sectional descriptive study was conducted on non - fermentative bacteria strains causing ventilator - associated pneumonia which were isolated at the Surgical Intensive Care Unit Department of Nghe An General Friendship Hospital from January 2020 to June 2021. Results: A total of 120 strains of non - fermenting Gram - negative bacteria were isolated. Of these, 85 strains were Acinetobacter baumannii, 31 strains was Pseudomonas aeruginosa. Acinetobacter baumannii has a resistance rate of more than 70% with all tested antibiotics, of which the highest resistance is to Ceftriaxone 96.9%. Pseudomonas aeriginosa was resistant to all tested antibiotics, with the highest resistance to Gentamycin80.0%, the lowest resistance to Piperacillin/Tazobactam 32.3%. Conclusion: Non - fermentative bacteria are the main pathogens of ventilator - associated pneumonia. The most common pathogens were Acinetobacter baumannii and Pseudomonas aeruginosa. These bacteria were highly resistant to the tested antibiotics. In which, A. baumannii resisted over 70% of the tested antibiotics, and P. aeruginosa resisted all tested antibiotics with varying degrees from 32.3 to 80.0%. Keywords: Ventilation associated pneumonia, VAP, P. aeruginosa, A. baumannii.


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