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在三个地理上不同的创伤重症监护病房中,多种耐药生物造成早期呼吸机相关肺炎的比较

Joseph M Swanson¹, Peyton C Cole², Julie E Farrar¹

¹Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy, Memphis, Tennessee, USA.

Surgical infections

|January 16, 2025

概括

地理位置没有影响多药耐药呼吸机相关肺炎 (VAP) 的总体发病率. 然而,特定的耐药生物和不适当的经验抗微生物疗法因单位而异,突出显示需要量身定制的治疗策略.

科学领域:

传染性疾病传染性疾病
关键护理医学关键护理医学
微生物学微生物学

背景情况:

呼吸机相关肺炎 (VAP) 是重症监护室的一个重大问题.
了解VAP的微生物原因和影响其患病率的因素对于有效治疗至关重要.
创伤重症监护室 (TICU) 的地理位置可能会影响导致VAP的生物类型.

研究的目的:

在三个地理上相隔的TICU中调查导致VAP的生物.
确定多药耐药 (MDR) VAP和不适当的实证抗菌疗法 (IEAT) 的发生率.
为了确定与MDR VAP相关的风险因素.

主要方法:

在三个信息通信中心对VAP案件进行了回顾性审查.
从入院后7天内从患者身上获得的支气管支气管洗 (BAL) 培养物的分析.
统计分析包括奇平方,克鲁斯卡尔-瓦利斯和多变量后勤回归.

主要成果:

在TICU中,MDR VAP的总体发病率相似 (33.8%47.6%).
格拉姆阴性MDR的患病率在TICU-1中更高,而格拉姆阳性MDR在TICU-3中更常见.
不适当的经验抗微生物治疗 (IEAT) 率在各个单位中不同于特定的MDR生物体. 在BAL和替代疗法 (KRT) 前几天的抗生素是MDR VAP的显著预测因素.

结论:

虽然整体MDR VAP率是一致的,但TICU之间具体的生物体概况有所不同.
IEAT率的变化表明需要对特定位置的经验性抗微生物治疗进行调整.
抗生素暴露和KRT是发展MDR VAP的关键风险因素.

关键词:

经验性的抗生素治疗.它具有多种药物耐药性.病原体是一种病原体.与呼吸机相关的肺炎.

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