An assessment of burden of hospital-acquired pneumonia among abdominal surgical patients in tertiary university hospital in Serbia: A matched nested case-control study

Abstract

BackgroundIn the population of abdominal surgical patients hospital-acquired pneumonia (HAP) significantly increases morbidity and mortality.Patients and methodsThrough regular hospital surveillance of patients who received abdominal operations, we identified postoperative HAP from 2007 to 2019. In an initial nested case-control study, every surgical patient with HAP was compared with three control patients without HAP. Control patients were matched to the cases by age, gender, the American Society of Anesthesiologists score, and type of surgical operation. Also, the patients with HAP, who died were compared with those who survived.ResultsMultivariate logistic regression analysis (MLRA) revealed that other postoperative infections, length of intensive care unit stay, use of H2RA, use of PPI/ H2RA, multiple transfusion, and use of vancomycin in surgical prophylaxis were independent RFs for occurrence of HAP. Also, MLRA identified that age, lenght of hospital stay, use of mechanical ventilation and ceftriaxone in HAP therapy were indepedenttly associated with poor outcome of HAP. All Acinetobacter baumannii isolates were resistant to aminoglycoside antimicrobial agents and showed carbapenem resistance. The most frequently used antibiotics in patients with HAP and without HAP were vancomycin and metronidazole, respectively.ConclusionOur study provided an insight into the burden of HAP in abdominal surgical patients, and highlighted several priority areas and targets for quality improvement.

Identification of Airborne Aerobic Bacteria in the Intensive Care Room using MALDI-TOF MS

“…However, it needs to be a concern for working staff that the finding of this bacteria in the air in the intensive care room needs special attention because several reports state that the finding of Acinetobacter baumanii, which is a bacterium that lives in moist environmental conditions and is an opportunistic bacterium that is commonly found in hospital or healthcare settings, is included in particular concern, especially when it is found in the community because of its natural resistance to antibiotics and its ability to experience high antibiotic resistance. Resistance to this bacterium is associated with a low immune system of infected patients or in ICUs with cases such as ventilator-associated pneumonia (VAP) or hospital-acquired pneumonia (HAP), skin and soft tissue infections, surgical site infection (SSI), bloodstream infections and CAUTI in patients treated in the ICU (32)(33)(34). Some studies reported that one of the most drug-resistant and clinically significant microorganisms in ICUs worldwide, antimicrobialresistant Acinetobacter baumannii, was found in dust on air conditioning vents, especially β-lactamase and carbapenem-producing strains in ICUs.…”