ABSTRACT
OBJECTIVE: To characterize mechanical ventilation-associated pneumonia (MVAP). METHOD: This is an observational descriptive study to characterize MVAP in 61 ventilated patients admitted in the intensive care units of the Hermanos Ameijeiras hospital during 2011. This study also aimed to isolate the bacteria causing MVAP and characterize their resistance to antibiotics. RESULTS: 51 (83.60%) patients presented pulmonary infiltrates and 35 (50.81%) presented a clinical score > 6 according to the Clinical Pulmonary Infection Score. Acinetobacter baumannii and Pseudomonas aeruginosa were the most frequently isolated microorganisms from patients with MVAP. Both microorganisms showed a high resistance to antibiotics. Carbapenems were the most frequent used antimicrobial therapeutic agents; elective antibiotic combinations were directed against both bacterial wall structure and nucleic acid synthesis. CONCLUSION: Patients with MVAP identified during the studied period showed similar frequency to those reported in medical literature. Thus, this study corroborated that this is still a relevant medical problem in this hospital. Acinetobacter baumannii and Pseudomonas aeruginosa were the most frequently isolated microorganisms from patients with MVAP. Antimicrobial treatment, empirical or not, are still the main risk factors for the development of multidrug-resistant strains of bacteria. The rate of resistance to antibiotics of Acinetobacter baumannii and Pseudomonas aeruginosa strains isolated from patients with MVAP was higher than those isolated from infected patients without MAVP. Tigecycline and colistin were the only antibiotics fully effective against Acinetobacter baumannii strains isolated in 2011 from patients with MVAP; against Pseudomonas aeruginosa strains, only colistin was fully effective.
Subject(s)
Female , Humans , Male , Middle Aged , Anti-Bacterial Agents/pharmacology , Gram-Negative Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Pneumonia, Ventilator-Associated/microbiology , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Intensive Care Units , Microbial Sensitivity TestsABSTRACT
Se realizó un estudio descriptivo longitudinal retrospectivo en el Laboratorio de Microbiología delHospital Universitario Ginecoobstétrico Mariana Grajales de Santa Clara, donde fueron procesadas todas las muestras de secreciones bronquiales de pacientes acoplados a ventilaciónmecánica, procedentes de cuatro Unidades de Cuidados Intensivos de esta provincia, entre los años 2004 y 2005. El objeto de estudio estuvo constituido por 634 cultivos de secreciones obtenidas mediante aspirados traqueales, a las que se aplicaron procedimientos cuantitativos, y se utilizaron como punto de corte más de 105 UFC/ml con el objetivo de demostrar la utilidad de la técnica del aspirado traqueal cuantitativo. Fueron identificados los microorganismos, y se realizó antibiograma por el método de difusión en disco de Kirby y Bauer. Se halló una positividad general de 34,1 por ciento y como gérmenes más frecuentes los bacilos gramnegativos no fermentadores (68,9 por ciento). Al analizar la sensibilidad antimicrobiana, se encontró que el Staphylococcus aureus fue muyresistente a la penicilina y sensible al cloramfenicol y a la oxacilina; la familia Enterobacteriaceae y el Acinetobacter resultaron altamente sensibles a los carbapenémicos, en tanto la Pseudomonas aeruginosa y la Stenotrophomona maltophilia lo fueron a la ciprofloxacina
A retrospective longitudinal, and descriptive study was conducted at the Microbiology Laboratory inthe Mariana Grajales Gynecobstetric University Hospital in Santa Clara where all bronchialsecretion samples from patients who received mechanical ventilation in four intensive care units ofthis province from 2004 to 2005, were processed. The study object was made up of 634 secretioncultures obtained by tracheal aspirations. These secretions were subjected to quantitativeprocedures. More than 105 UFC/mL, were used with the aim of demonstrating how much useful isthe quantitative tracheal aspiration technique. Microorganisms were identified and an antibiogramwas done by the Kirby Bauer Disk Difussion Method. A 34,1% of general positivity was found andnon-fermenting Gram-negative bacilli were the germs most frequently found (68,9 %). Once theantimicrobial sensibility was analyzed, we discovered Staphylococcus aureus was too resistant topenicillin and sensitive to cloranfenicol and oxacillin. The family Enterobacteriaceae andAcinetobacter turned out to be highly sensitive to carbapenemics. On the other hand the familyPseudomonas aeruginosa and Stenotrophomona maltophilia turned out to be highly sensitive tociprofloxacin.