Distribution and antibiotic resistance of bacterial induced ventilator - associated pneumonia at the intensive care unit
Journal Title: JOURNAL OF FUNCTIONAL VENTILATION AND PULMONOLOGY - Year 2017, Vol 8, Issue 25
Abstract
Introduction and Objective. Ventilator - associated pneumonia (VAP) is a severe disease with high mortality. The bacteria causing VAP have been varied between countries, hospitals, and change over time. The empiric choice of antibiotics as the first-line should be based on microbiological data and on-site antibiotic resistance. This retrospective study aimed to evaluate: 1) the change in distribution of bacterial induced pneumonia; 2) the modification of bacterial antibiotic resistance; 3) the first-line therapy of antibiotics for VAP in intensive care unit. Results. During 7 years, 748 samples were collected. Three types of bacteria accounting for the highest rates over the years were A. baumannii, Klebsiella spp, and Pseudomonas spp. Other bacteria accounting for a small proportion were Enterobacter spp, E. coli, S. aureus, etc. A. baumannii was always accounted for the highest proportion over the years: in 2016, it was 38%. The percentage of Klebsiella spp, Pseudomonas spp was varied over years without significant difference: in 2016, it was accounted for 30% and 17%, respectively. A. baumannii resistance was >80% with cefepime, ceftazidime, imipenem, meropenem, piperacillin/tazobactam (PTZ), quinolone, and aminoglycoside; the resistance to cefoperazone/sulbactam, and doxycycline was varied over the years: in 2016, it was 7.1% and 26.7%, respectively. There was no record for the resistance to polymyxin B from 2012- 2016. Klebsiella spp resistance was high: >80% to ceftazidime, cefoperazone, cefepim, and quinolone; >70% to PTZ, ampicillin/sulbactam (2016); the resistance to cefoperazone/sulbactam, amikacin was varied over the years: in 2016, it was accounted for 42.1% and 14.8%, respectively. The resistance to meropenem and imipenem was varied over the years: in 2016, it was 71.4% and 72.4%, respectively. There was no record of resistance to polymyxin B over the years. Pseudomonas spp was highly resistant to ceftazidime, cefepim, and PTZ in 2010, 2011; the resistant rate was decreased in the last two years: in 2016, it was reported for 41.2%, 41.2%, and 14.3%, respectively. The resistance to cefoperazone/sulbactam was 75.9% in 2010 and 30.8% in 2016. The resistance to levofloxacin and ciprofloxacin was high over the years: in 2016, it was about 64.7% and 58.8%, respectively. The resistance to amikacin was varied over the years; it was 43.8% in 2016. The resistance to imipenem and meropenem was high, but gradually reduced in the last two years: in 2016, it was 47.1%. Polymyxin B had not been recorded for the resistance from 2012-2015. However, in 2016, it was reported 5.9% for polymyxin B resistance. Conclusion. Bacteria causing VAP was mainly negative Gram bacteria. The three most commonly presented bacteria included A. baumannii, Klebsiella spp, Pseudomonas spp. A. baumannii was highly resistant to many groups of antibiotics.
Authors and Affiliations
PHAM Luc
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- EP ID EP367909
- DOI 10.12699/jfvpulm.8.25.2017.29
- Views 66
- Downloads 0
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