Neumonia Nosocomial

Ostos, Olga Lucía; Cifuentes, Yolanda; Barbosa, Rubinsten Hernández; Molina, Liliana Muñoz

doi:10.22490/24629448.365

Cited by 1 publication

(1 citation statement)

References 34 publications

(42 reference statements)

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“…[34] Microorganisms of the Enterobacteriaceae family, chiefl y E. coli and K. pneumoniae, are also reported frequently in association with VAP. [35,36] A study in a hospital in eastern Cuba found percentages of enterobacterial infection in VAP patients similar to those in this study. [37] However, in our research, the prevailing Enterobacteriaceae species in VAP patients was S. marcescens, in contrast with other studies reviewed.…”

Section: Discussionsupporting

confidence: 83%

Nosocomial Ventilator-Associated Pneumonia in Cuban Intensive Care Units: Bacterial Species and Antibiotic Resistance

Medell

Hart²,

Duquesne

et al. 2013

MEDICC Review

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INTRODUCTION Nosocomial pneumonia associated with use of mechanical ventilators is one of the greatest challenges confronted by intensivists worldwide. The literature associates several bacteria with this type of infection; most common in intensive care units are Acinetobacter baumannii, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus and some of the Enterobacteriaceae family.OBJECTIVES To identify the causal agents of nosocomial ventilatorassociated pneumonia in patients receiving mechanical ventilation in the intensive care units of Havana's Hermanos Ameijeiras Clinical-Surgical Teaching Hospital in 2011, and to characterize their antibiotic resistance. METHODS A cross-sectional descriptive study was conducted using hospital administrative data of quantitative cultures from positive tracheal aspirates for January through December, 2011. Records were analyzed from 77 intensive care unit patients who developed nosocomial ventilator-associated pneumonia. Variables examined were age and sex, and pathogens identifi ed from culture of tracheal aspirate and related antibiotic susceptibility.RESULTS Species most frequently isolated were: Acinetobacter baumannii in 53 patients (68.8%), Pseudomonas aeruginosa in 34 patients (44.2%), other species of Pseudomonas in 15 patients (19.5%), and Serratia marcescens, Klebsiella pneumoniae, and Escherichia coli in 12 patients each (15.6%). Some patients presented more than one pathogen in concurrent or successive infections. Antimicrobial susceptibility testing found high percentages of resistance to antibiotics in all these pathogens. Least resistance was found to colistin. CONCLUSIONSThe prevalence of antibiotic resistance in bacteria causing nosocomial ventilator-associated pneumonia is of concern. Colistin is the drug of choice among the antibiotics reviewed, but sensitivity to other antibiotics should be assessed to search for more appropriate broad-spectrum antibiotics for treating nosocomial ventilator-associated pneumonia. Our results also suggest the need to strengthen infection control efforts, particularly in intensive care units, and to reassess compliance with quality control procedures. Multidisciplinary research involving microbiologists, epidemiologists, internists and intensivists is needed to fully understand the etiological and resistance patterns observed.

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Section: Discussionsupporting

confidence: 83%