Viktoryia Ziamko
Vitebsk State Medical University, Belarus
Title: Etiological structure and antimicrobial resistance of pathogens isolated from patients with ventilator-associated pneumonia
Biography
Biography: Viktoryia Ziamko
Abstract
Objective: to investigate the etiological structure and antimicrobial resistance of pathogensisolated from patients with ventilator-associated pneumonia.
Materials and methods.We examined sputum of 49 patients with ventilator-associated pneumonia. The criterion for selection of patients was the duration of mechanical ventilation for at least 48 hours.
Results.Staphylococcus aureus was found in 33.3% specimens, Acinetobacter spp. –in33.3%, Pseudomonas aeruginosa–in 15.4 %, Klebsiella pneumoniae- in 7.7%, Candida– in 12,8%, Streptococcus spp.–in 2,6% specimens.Staphylococcus aureus was sensitive to vancomycin in 100% of casesand to amikacin in 38.5 % of cases. All strains ofStaphylococcus aureus were methicillin-resistant. 100% of strains were resistant to ofloxacin, ciprofloxacin, levofloxacin, 92,3% - toclindamicin.
Isolates of Pseudomonas aeruginosawere sensitive to colistinin 100% of cases, to amikacin in 16.6% of cases.All isolates of Pseudomonas aeruginosa were resistant to meropenem, imipenem, cefepime, ceftazidime, cefoperazone, ciprofloxacin.
46.2% of isolates of Acinetobacter spp. were sensitive to ampicillin in combination with sulbactam.92.3% of isolates of Acinetobacter spp. were sensitiveto cefoperazone-sulbactam. Acinetobacter spp. was resistant to amikacin, meropenem, imipenem, levofloxacin, cefoperazone, cefepime, ciprofloxacin.
All isolates of Klebsiella pneumoniae were sensitive to imipenem, 66.7% of Klebsiella pneumoniae- to meropenem and amikacin. Klebsiella pneumoniae was resistant to amoxicillin, cefotaxime, ceftazidime, ciprofloxacin, cefoperazone, ofloxacin in 100% of cases.
Conclusions.
1. Modern epidemiological feature of ventilator-associated pneumonia is the prevalence in the etiological structure of gram-negative microflora, represented mainly by Acinetobacter spp.
2. It is recommended to use vancomycin or linezolidagainst Staphylococcus aureus, colistin againstPseudomonas aeruginosa,cefoperazone-sulbactam against Acinetobacter spp. and imipenem against Klebsiella pneumoniae.