MIKROBIOLOGICZNA CHARAKTERYSTYKA ZAPALEŃ PŁUC U PACJENTÓW ODDZIAŁU INTENSYWNEJ TERAPII
[MICROBIOLOGICAL CHARACTERIZATION OF PNEUMONIA IN PATIENTS OF INTENSIVE CARE UNIT]

Streszczenie.

Badaniami objęto grupę 30 chorych OITiA Wojewódzkiego Szpitala Specjalistycznego im. L. Rydygiera w Krakowie z klinicznym podejrzeniem szpitalnego zapalenia płuc. Od pacjentów pobrano aspiraty tchawicze na posiew ilościowy, celem określenia czynnika etiologicznego. Najczęściej izolowano pałeczki niefermentujące (153): P. aeruginosa (77) i A. baumannii (57) oraz pałeczki z rodziny Enterobacteriacae (77). Zaobserwowano niski stopień wrażliwości szczepów P. aeruginosa na karbapenemy, wynoszący dla imipenemu 25,8% oraz dla meropenemu 30,8%.

Abstract.

The aim of study was bacteria characterization, isolated from 30 patients with microbiologically confirmed pneumonia, hospitalized in ICU of Rydygier’s Hospital in Krakow. In the study, endotracheal aspirates (ETA) were being collected and quantitatively inoculated. Bacteria isolation at the concentration of ≥106 CFU/ml was recognized as bacteriological etiology of pneumonia. Studied 140 clinical materials and isolated 251 bacterial strains from 16 divers species. Isolation of bacteria
at the concentration of ≥ 106 CFU/ml, on the day of clinically recognized HAP, was observed in 26
patients and presence of 1 species of bacteria at the pathological concentration was detected in 17
patients. In the study of endotracheal aspirates, which were collected after 3 and 6 days of treatment,
isolation of bacteria species at the significant concentration was observed appropriate in 15 and 10
patients. In the etiology of infections predominated: P.aeruginosa, A. baumannii, S. maltophilia (17
strains; 47,2%) and Enterobacteriaceae bacilli (12 strains; 33%), including bacilli ESBL-positive. The
surveillance of bacterial susceptibility patterns detected high percentage of resistance P. aeruginosa strains to imipenem (38,7%).