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| Format: | Artículo científico |
| Language: | en |
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Medical Education Cooperation with Cuba
2013
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| Online Access: | https://www.redalyc.org/articulo.oa?id=437542093006 |
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Table of Contents:
- Nosocomial Ventilator-Associated Pneumonia in Cuban Intensive Care Units: Bacterial Species and Antibiotic Resistance Manuel Medell Marcia Hart Amílcar Duquesne Fidel Espinosa Rodolfo Valdés Medicina Cuba bacte ventilator rial resistance associated pneumonia 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 Aci-netobacter baumannii, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus and some of the Enterobacteriaceae family.OBJECTIVES To identify the causal agents of nosocomial ventilator-associated 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 tra-cheal aspirates for January through December, 2011. Records were analyzed from 77 intensive care unit patients who developed nosoco-mial 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 bau-mannii 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 sus-ceptibility testing found high percentages of resistance to antibiotics in all these pathogens. Least resistance was found to colistin.CONCLUSIONS The prevalence of antibiotic resistance in bacte-ria causing nosocomial ventilator-associated pneumonia is of con-cern. 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. 2013 artículo científico 1555-7960 https://www.redalyc.org/articulo.oa?id=437542093006 en http://www.redalyc.org/revista.oa?id=4375 MEDICC Review application/pdf Medical Education Cooperation with Cuba MEDICC Review (Estados Unidos de América) Num.2 Vol.15