title: Bacteriological Assessment of Pneumonia Caused by Gram-Negative Bacteria in Patients Hospitalized in Intensive Care Unit.
abstract: The article presents the results of 11-year study (2005-2015) of Gram-negative bacteria responsible for pneumonia in 2033 mechanically ventilated patients hospitalized in Intensive Care Unit. Of 8796 biological samples, consisting mainly of bronchial aspirate (97.9 %), 2056 bacterial strains were isolated and subjected to identification. VITEK 2 was used to determine drug susceptibility (classified according to the EUCAST criteria). ESBL, MBL and KPC-producing strains were identified by means of phenotypic methods using appropriate discs. The findings were that the predominant bacteria responsible for infections consisted of Enterobacteriaceae (42.0 %), Acinetobacter baumannii (37.2 %), Pseudomonas aeruginosa (16.1 %), and Stenotrophomonas maltophila (4.7 %). We observed a rise in the number of bacteria causing pneumonia throughout the study period, especially in S. maltophila and Enterobacteriaceae ESBL (+). Gram-negative bacilli were 100 % susceptible to colistin, apart from naturally resistant strains such as Proteus mirabilis, Serratia marcescens, whereas Enterobacteriaceae ESBL (+) were susceptible to imipenem and meropenem. Acinetobacter baumannii strains exhibited the lowest drug susceptibility. In conclusion, we report an increase in the prevalence of pneumonia associated with Gram-negative bacteria in mechanically ventilated intensive care patients. Colistin remains the most effective drug against the majority of Gram-negative bacteria. Therapeutic problems are common in the course of treatment of Acinetobacter baumannii infections.
authors.affiliation: Department of Medical Diagnostics, Military Institute of Medicine, Warsaw, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Guzek
authors.affiliation: Department of Epidemiology and Tropical Medicine, Military Institute of Medicine, 128 Szaserów Street, 04-141, Warsaw, Poland. kktropmed@wp.pl.
authors.forename: K
authors.initials: K
authors.lastname: Korzeniewski
authors.affiliation: Clinic of Anesthesiology and Intensive Care, Military Institute of Medicine, Warsaw, Poland.
authors.forename: D
authors.initials: D
authors.lastname: Tomaszewski
authors.affiliation: Clinic of Anesthesiology and Intensive Care, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Z
authors.initials: Z
authors.lastname: Rybicki
authors.affiliation: Department of Gynecology, Holy Family Maternity Hospital, Warsaw, Poland.
authors.forename: E
authors.initials: E
authors.lastname: Zwolińska
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests; D010343:Patient Admission; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D053717:Pneumonia, Ventilator-Associated / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D012121:Respiration, Artificial / Q000009:adverse effects*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Bacteria identification; Bacterial strains; Drug susceptibility; Gram-negative bacteria; Intensive care; Pneumonia prevalence