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Wyświetlanie 1-3 z 3
Tytuł:
Analiza zastosowanych terapii empirycznych w leczeniu VAP spowodowanego przez Acinetobacter baumannii
Analysis of applied empirical treatments against VAP caused by Acinetobacter baumannii
Autorzy:
Grochowalska, Aneta
Kozioł-Montewka, Maria
Powiązania:
https://bibliotekanauki.pl/articles/1195811.pdf
Data publikacji:
2017
Wydawca:
Instytut Medycyny Wsi
Opis:
Cel pracy. Celem pracy była analiza szczepów A. baumannii, wyizolowanych z próbek szpitalnych z BAL od pacjentów z objawami VAP, hospitalizowanych w Oddziale Intensywnej Terapii (OIT) w szpitalu w Radomiu w latach 2012–2014. Dokonano oceny częstości występowania i wrażliwości na leki tych niefermentujących pałeczek oraz porównano algorytm postępowania przeciwbakteryjnego u chorych z obowiązującymi rekomendacjami. Materiał i metody. Badanie zrealizowane w okresie od 1 stycznia 2012 roku do 31 grudnia 2014 roku, które przeprowadzono w OIT u chorych z rozpoznaniem VAP, miało charakter retrospektywny. Przeanalizowano czynniki obciążające pacjentów, od których izolowano A. baumannii. Wyniki. Przeprowadzono badania u 755 pacjentów z podejrzeniem VAP. U 141 pacjentów z potwierdzonym VAP wyhodowano A. baumannii. Ponadto wśród badanej grupy u 34 osób wyizolowano A. baumannii oraz dodatkowo drugi gatunek innego typu, uważany za czynnik etiologiczny biorący udział w koinfekcji. Znaczna część szczepów A. baumannii wyróżniała się wysoką opornością (> 90%) na wybrane antybiotyki. Analiza zastosowanego leczenia empirycznego wykazała poziom trafności terapii wobec A. baumannii we wczesnym VAP w 31%, a dla pozostałych gatunków w 57%, podczas gdy w późnym VAP trafność terapii wobec A. baumannii wyniosła 11%, a dla gatunków powodujących koinfekcję – 24%. U chorych z wczesnym rozpoznaniem VAP po celowanym leczeniu antybiotykami poprawa stanu klinicznego wystąpiła u 35% pacjentów, natomiast u chorych z późnym VAP – u 61% chorych. Wnioski. W przeprowadzonym badaniu zaobserwowano zakażenia wywołane przez wielooporne A. baumannii u chorych z VAP, co należy wziąć pod uwagę przy wyborze empirycznego leczenia antybiotykowego. Jednocześnie należy uwzględnić lokalne wzorce oporności wielolekoopornych Gram-ujemnych pałeczek powodujących koinfekcje w VAP w leczeniu empirycznym.
Objective. The aim of the study was analysis of A. baumannii strains, isolated from hospital samples from the lower respiratory tract collected from patients with VAP hospitalized in Masovian Specialist Hospital’s ICU in Radom between 2012 and 2014. The frequency of occurrence and drug susceptibility of these bacteria was evaluated, as well as the applied empirical treatment and its effectiveness in ICU with the recommendations in effect. Materials and method. Retrospective study was conducted during the period from 1 January – 31 December 2014, in ICU among patients with the diagnosis of VAP, aggravating factors were analyzed and A. baumannii isolated. Results. Studies included 755 patients with the suspicion of VAP. A. baumannii was isolated in 141 patients with confirmed VAP. Moreover, in the examined group, in 34 patients in addition to A. baumannii another strain was isolated, considered as etiological factor participating in coinfection. A considerable part of A. baumannii strains were characterized by high resistance (> 90%) to selected antibiotics. Analysis of the empirical treatment applied showed that the level of accuracy of therapy for A. baumannii in early VAP was 31%, and for the remaining strains – 57%, while in late VAP the sensitivity of A. baumannii was 11% and for the species causing coinfection – 24%. In patients with an early diagnosis of VAP, after targeted antibiotic therapy an improvement of clinical condition was observed in 35% of patients, whereas in those with late diagnosis – in 61% of patients. Conclusion. In the conducted study, infections caused by multi-resistant A. baumannii were observed more frequently in late VAP, which should be taken into consideration while choosing empirical antibiotic therapy. Simultaneously, the local resistance patterns of multi-drug-resistant Gram-negative strains co-infecting VAP should be considered in empirical treatment. Moreover, both additional clinical complication and co-infections contribute to more severe course of diseases.
Źródło:
Medycyna Ogólna i Nauki o Zdrowiu; 2017, 23(52), 3
2083-4543
Pojawia się w:
Medycyna Ogólna i Nauki o Zdrowiu
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Analysis of Acinetobacter baumannii resistance patterns in patients with chronic obstructive pulmonary disease (COPD) in terms of choice of effective empiric antibiotic therapy
Autorzy:
Grochowalska, Aneta
Kozioł-Montewka, Maria
Sobieszczańska, Anna
Powiązania:
https://bibliotekanauki.pl/articles/989765.pdf
Data publikacji:
2017
Wydawca:
Instytut Medycyny Wsi
Tematy:
copd
antibiotics
acinetobacter baumannii
multidrug-resistant strains
co-infection
Opis:
Introduction. Multi-resistant Acinetobacter baumannii isolated from patients has become one of the most hazardous pathogens in health care settings. The aim of the study was to analyze pneumonia caused by Acinetobacter baumannii in patients hospitalized because of exacerbation of chronic obstructive pulmonary diseases (COPD), who were admitted to the Pulmonology Ward of the Masovian Specialistic Hospital in Radom (MSS). The incidence and drug sensitivity of these non-fermenting rods were evaluated, and compliance with antimicrobial procedure with the algorithm of the guidelines in applicable recommendations, was estimated. This should result in determining the local patterns of resistance and verifying therapeutic procedures in accordance with the assumptions of hospital antibiotic policy. In addition, the study examined the effectiveness of empiric and targeted therapy according to the clinical condition of the patient, and the eradication of A. baumannii, in comparison with the aggravating factors of the patient. Materials and Method. The retrospective study included 90 patients with exacerbation of COPD whose etiological factor of infection was A. baumannii, hospitalized in the Department of Pulmonology (MSS) in 2012–2016. Results. Studies were conducted on 90 patients with COPD exacerbation from which A. baumannii was isolated. Co-infections with other bacterial species among 41 patients were additionally noted. The majority of A. baumannii strains showed a high resistance (90%) to fluoroquinolones, ceftazidime, piperacillin/tazobactam. For strains causing a co-infection, drug resistance was successively 44–56%, 44%, 44%. All of patients received empirical therapy. The most commonly used drug was amoxicillin with a clavulanic acid, often combined with fluoroquinolone. This type of therapy was effective among 10% of patients. The mortality in this group was determined at 29%. Among 79% of patients with COPD, a targeted therapy was performed which proved to be effective in 58% of treated cases by susceptibility testing. The highest efficacy was observer after the use of colistin and carbapenems. Conclusion. In the performed study, the infections caused by multi-resistant Acinetobacter baumannii, were observed in COPD, which should be taken into consideration in choosing empirical antibiotic therapy. Simultaneously, the local resistance patterns of multi-drug-resistant (MDR) Gram-negative strains co-infecting COPD should be considered in empirical treatment. Moreover, both additional clinical complication and co-infections contribute to a more severe course of diseases. In this study, the mortality percent exceeded 29%.
Źródło:
Annals of Agricultural and Environmental Medicine; 2017, 24, 2
1232-1966
Pojawia się w:
Annals of Agricultural and Environmental Medicine
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Ventilator-associated pneumonia (VAP) caused by Acinetobacter baumannii in view of the microbial properties of the ESKAPE group in neighbouring countries - Poland and Ukraine
Autorzy:
Grochowalska, Aneta
Kozioł-Montewka, Maria
Oliynyk, Oleksandr
Krasij, Natalia
Powiązania:
https://bibliotekanauki.pl/articles/972522.pdf
Data publikacji:
2017
Wydawca:
Instytut Medycyny Wsi
Tematy:
resistance to antibiotics
VAP
ESKAPE
Acinetobacter baumannii
Opis:
The increase in the clinical threat of ESKAPE pathogens is associated with high virulence and the presence of numerous mechanisms of antimicrobial resistance. The above characteristics of pathogens affect therapeutic failures as well as cause prolongation and increase of the cost of its treatment. Objective. The aim of this study was to evaluate and analyze Acinetobacter baumannii strains in relation to the remaining bacteria from the ESKAPE group that induced pneumonia in mechanically ventilated patients in two neighboring countries. Materials and method. The study was retrospective. 335 clinical materials were analyzed, mainly bronchoalveolar lavage gained for microbiological screen. The analyzed patients were in intensive care units (ICU) in selected hospitals in 2013 –2015, in Poland (154 patients) and in Ukraine (181 patients). Results. In the analysis of etiological agents of VAP caused by ESKAPE strains, Gram negative bacteria were predominant in both countries although particular species occurred at different frequencies in Poland and Ukraine. Multi-resistant strains of Acinetobacter baumannii were more frequently cultured from patients in Poland (26.9%) compared to those from Ukraine (14.6%).
Źródło:
Journal of Pre-Clinical and Clinical Research; 2017, 11, 2; 111-115
1898-2395
Pojawia się w:
Journal of Pre-Clinical and Clinical Research
Dostawca treści:
Biblioteka Nauki
Artykuł
    Wyświetlanie 1-3 z 3

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