Characterization of the microflora of ventilator-associated respiratory tract infections in patients with severe trauma


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Abstract

Rationale The relevance of ventilator-associated respiratory tract infections in severe injury patients (SIP) is associated with both features of causative pathogens and the initial severity of the state of patients. Among causative pathogens nosocomial flora is dominant. Purpose - to perform an analysis of the microbiological monitoring of ventilator-associated respiratory tract infections in SIP. The analysis was based on the results of a prospective epidemiological, clinical, and instrumental study of 100 SIP with ventilator-associated respiratory tract infections, stayed in the surgical intensive care unit. The proportion of ventilator-associated respiratory infections in the structure of nosocomial infections in these patients is between 90 - 95%, at that there was revealed the prevalence of nosocomial pneumonia (61%). Ventilator-associated respiratory tract infection most commonly occurs during the first 10 days of mechanical ventilation. The prevailing flora was represented by Gram negative Acinetobacter baumamnnii (40.3 ± 2.1%) and Pseudomonas aeruginosa (38.4% ± 3.2%). Isolated microorganisms possessed multiple antibiotic resistance, with the greatest extent to aminoglycosides - 69.5%, fluoroquinolones - 40.3%, penicillin - 37.6%; cephalosporins (third generation) - 33.8%. There is noted marked preponderance of microbial associations compared with monocultures 57.1 ± 5.3%.

About the authors

O. A Orlova

City Clinical Hospital № 8; South-Ural State Medical University Russian

Email: oksana_orlova@bk.ru
канд. мед. наук, зав. эпидемиологическим отделом МБУЗ Городская клиническая больница №8; доцент каф. гигиены и эпидемиологии ГБОУ ВПО «Южно-Уральский государственный медицинский университет» Chelyabinsk, Russian Federation

V. G Akimkin

Scientific Research Institute for Desinfectology of the Federal Service for the Oversight of Consumer Protection and Welfare; I.M. Sechenov First Moscow State Medical University; Central Research Institute of Epidemiology of the Federal Service for the Oversight of Consumer Protection and Welfare

член-кор. РАН, доктор мед. наук, проф., заместитель директора ФБУН «НИИ дезинфектологии» Роспотребнадзора, зав. каф. дезинфектологии ГОУ ВПО Первый МГМУ им. И.М. Сеченова, вед. науч. сотр. ФБУН «Центральный НИИ эпидемиологии» Роспотребнадзора Moscow, Russian Federation

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