在越南的一个重症监护病房中对呼吸机相关的肺炎进行临床和微生物学评估
Kayoko Hayakawa1,2, Nguyen Gia Binh3, Dao Xuan Co3
1Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
Infection prevention in practice
|November 29, 2023
概括
耐多药格拉姆阴性细菌导致全球的呼吸器相关肺炎 (VAP). 在越南,Acinetobacter baumannii VAP的死亡率很高,广泛的抗卡巴胺耐药性表明紧急的治疗和预防策略.
科学领域:
- 传染性疾病 传染性疾病
- 临界护理医学 临界护理医学
- 基因组学就是基因组学.
背景情况:
- 由多药性耐药格拉姆阴性细菌引起的呼吸机相关肺炎 (VAP) 是日益严重的全球健康问题.
- 了解东南亚的VAP流行病学对于改善患者的治疗结果和治疗策略至关重要.
研究的目的:
- 在越南的一个重症监护室 (ICU) 调查VAP的流行病学.
- 描述导致VAP的关键细菌病原体的抗微生物耐药性和基因组概况.
主要方法:
- 从2015年10月到2017年3月,在越南的ICU中进行了前性队列研究.
- 包括VAP和阳性呼吸道培养的患者;对Acinetobacter baumannii分离物进行全基因组测序 (WGS).
主要成果:
- 125名患者 (137次VAP发作) 从1699名入院者中被确定.
- 最常见的病原体是Acinetobacter baumannii (67.2%),表现出多种药物耐药性,包括对美洛和levofloxacin.
- 30天死亡率为55.2%,在患有A. baumannii感染的患者中显著高 (65%).
结论:
- 在这个越南ICU中,由A. baumannii引起的VAP与高死亡率有关.
- A. baumannii和Klebsiella pneumoniae表现出高水平的多药性耐药性,包括对卡巴胺的耐药性 (分别为97%和70%).
- 据WGS建议复杂的克隆传播,突出了针对性干预的必要性.
相关概念视频
01:30Pneumonia III: Complications and Assessment
239
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
239
01:30Pneumonia V: Nursing management and Prevention
2.1K
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
2.1K
01:28Pneumonia IV: Management
333
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
333
01:30Pneumonia I: Introduction
245
Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
245
01:29Pneumonia II: Pathophysiology
285
The pathophysiology of pneumonia involves the following steps:
285
01:20Sputum Studies II: Culture and Sensitivity
348
Description
Sputum culture and sensitivity is a medical procedure used to diagnose bacterial infections in the respiratory tract and select the most appropriate antibiotics for treatment. This process involves analyzing sputum samples of thick and opaque secretions produced in the lungs and airways. These samples are collected from patients and then sent to the laboratory for analysis.
The test can identify various pathogens responsible for respiratory infections, including Streptococcus,...
Sputum culture and sensitivity is a medical procedure used to diagnose bacterial infections in the respiratory tract and select the most appropriate antibiotics for treatment. This process involves analyzing sputum samples of thick and opaque secretions produced in the lungs and airways. These samples are collected from patients and then sent to the laboratory for analysis.
The test can identify various pathogens responsible for respiratory infections, including Streptococcus,...
348