کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3358645 1591760 2015 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Five-year trends for ventilator-associated pneumonia: Correlation between microbiological findings and antimicrobial drug consumption
ترجمه فارسی عنوان
روندهای پنج ساله برای پنومونی مرتبط با تهویه: ارتباط بین یافته های میکروبیولوژیکی و مصرف داروهای ضد میکروبی
کلمات کلیدی
موضوعات مرتبط
علوم زیستی و بیوفناوری ایمنی شناسی و میکروب شناسی میکروبیولوژی و بیوتکنولوژی کاربردی
چکیده انگلیسی


• Five-year trends in ventilator-associated pneumonia (VAP) microbial aetiology and antibiotic consumption were analysed.
• Enterobacteriaceae were found to be more often responsible for VAP than Pseudomonas aeruginosa.
• This was the result of a significant increase in AmpC-producing bacteria.
• Concomitantly, third-generation cephalosporin consumption increased over time.
• The incidence of P. aeruginosa and MRSA remained stable.

The epidemiology of multidrug-resistant bacteria (MDRB) has changed significantly in European healthcare settings, with a decrease in frequency of meticillin-resistant Staphylococcus aureus and an increase in extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae. Little is known about the effects of these changes on ventilator-associated pneumonia (VAP). A retrospective 5-year trend analysis of ICU antibiotic consumption and resistance in bacteria causing VAP was undertaken. Poisson regression analysis between complete microbiological data and antibiotic consumption was performed. In total, 252 episodes of VAP in 184 patients were identified between 2007 and 2011, from which 364 causal bacteria were isolated. Enterobacteriaceae isolation rates increased significantly over this period [from 6.64 to 10.52 isolates/1000 patient-days; P = 0.006], mostly due to an increase in AmpC-producing Enterobacteriaceae (APE) (2.85–4.51 isolates/1000 patient-days; P = 0.013), whereas the number of episodes due to S. aureus and Pseudomonas aeruginosa remained stable. A positive association was found between the increase in APE infections and an increase in past-year antibiotic consumption: amoxicillin/clavulanic acid (P = 0.003), ceftazidime and cefepime (P = 0.007), carbapenems (P = 0.002), fluoroquinolones (P = 0.012), macrolides (P = 0.002) and imidazoles (P = 0.004). No such association was found for the emergence of resistance in P. aeruginosa. These results indicate a change in the epidemiology of VAP, with Enterobacteriaceae exceeding P. aeruginosa and S. aureus. Moreover, a positive correlation was observed between antibiotic consumption and the incidence of potentially MDRB such as APE. No such correlation was found for ESBL-producing Escherichia coli and antibiotic-resistant P. aeruginosa.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Journal of Antimicrobial Agents - Volume 46, Issue 5, November 2015, Pages 518–525
نویسندگان
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