Role of Multidrug-resistant Pathogens in Ventilator-Associated Pneumonia in a Tertiary Care Hospital in India
محل انتشار: میکروبیولوژی بالینی و عفونت، دوره: 9، شماره: 2
سال انتشار: 1401
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 102
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شناسه ملی سند علمی:
JR_JCMI-9-2_001
تاریخ نمایه سازی: 28 تیر 1402
چکیده مقاله:
Aim: Ventilator-associated pneumonia (VAP) is the second most common infection acquired in the
intensive care unit (ICU). Bacteriological profiles cause VAP and their susceptibility patterns vary in
different institutions.
Methods: A prospective study was conducted from June ۲۰۱۷ to May ۲۰۱۸ in a tertiary care hospital as per
the recent NHSN guidelines in finding the incidence of VAP and further determining the etiological agents
by both conventional and automated methods. The combination disk method (Phenotypic confirmatory
test), ampicillin C (AmpC) disk test, modified carbapenem inactivation method, imipenem/ethylenediamine
tetraacetic acid combined disc test, and cefoxitin disk test were performed for the detection of extendedspectrum
beta-lactamases (ESBL), AmpC β-lactamases, carbapenemases, metallo-beta-lactamases (MBL),
and methicillin-resistant Staphylococcus aureus, respectively.
Results: Among ۱۰۴ patients, ۳۱ cases developed PVAP (possible VAP) during their ICU stay; of these
cases, two patients had two episodes of VAP each, and the incidence of VAP was ۳۲%. The most common
isolate was Acinetobacter baumannii (۳۸%), followed by Pseudomonas aeruginosa (۲۲%), Klebsiella
pneumoniae (۱۶%), and Escherichia coli (۱۳.۵۱%). Twenty (۵۴%) of the ۳۷ VAP pathogens were multidrug
resistant. ESBL was produced by ۴۰% and ۶۷% of E. coli and K. pneumoniae, respectively. MBL was
produced by ۲۵% of P. aeruginosa. In addition, AmpC beta-lactamases were produced by ۱۸% each of the
Enterobacteriaceae and non-fermenters, respectively. One of the two S. aureus isolates was methicillinresistant.
Conclusion: The majority of VAP cases in our setting were caused by highly resistant strains. The frequency
of specific multidrug resistance pathogens causing VAP may vary due to hospital, patient population,
exposure to antibiotics, type of ICU patients, and changes over time, emphasizing the need for timely local
surveillance data.
کلیدواژه ها:
Ventilator-associated pneumonia ، Extended-spectrum beta-lactamase ، Modified carbapenem inactivation method ، Intensive care unit ، Metallo-beta-lactamase ، Multidrug resistance
نویسندگان
Sadiya Fatima
Department of Microbiology, Gandhi Medical College and Hospital, Secunderabad, Telangana, India
Mustafeed Uddin
Department of Microbiology, Gandhi Medical College and Hospital, Secunderabad, Telangana, India
P.L Tapasya Rao
Department of Microbiology, Gandhi Medical College and Hospital, Secunderabad, Telangana, India
S Rajeshwar Rao
Department of Microbiology, Gandhi Medical College and Hospital, Secunderabad, Telangana, India