KHẢO SÁT ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ CĂN NGUYÊN VI KHUẨN GÂY VIÊM PHỔI LIÊN QUAN THỞ MÁY TẠI KHOA HỒI SỨC TÍCH CỰC VÀ CHỐNG ĐỘC BỆNH VIỆN ĐA KHOA TỈNH VĨNH PHÚC

Abstract

Objective: To describe the clinical, subclinical, and microbiological characteristics of patients with ventilator-associated pneumonia in the intensive care - poison control department at Vinh Phuc General Hospital. Material and methods: A cross-sectional descriptive study was conducted on 33 patients diagnosed with VAP according to the 2016 ATS/IDSA guidelines from March 1, 2023, to September 30, 2023, at the Department of Intensive Care - Poison Control, Vinh Phuc General Hospital. Bronchoalveolar lavage (BAL) specimen cultures, and ³ 10³ colony-forming units/mL for diagnosis of VAP. Results: A majority of the patients (60.6%) had late-onset VAP. Laboratory examinations showed 63.6% had leukocytosis, only 6.1% had leucopenia (<4 G/l), and 84.8% of patients had PCT concentrations > 0.5ng/ml, of which 60.6% of cases had PCT > 2ng/ml. Bilateral pulmonary lesions were found in 69.7% of the patients. BAL specimen culture results showed that the positive culture rate was 72.7%. The most common pathogenic microorganism spectra were Acinetobacter baumannii accounting for 40.0%, followed by Pseudomonas aeruginosa (36.0%). Antimicrobial susceptibility testing showed that except for Colistin, Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae were resistant to empiric antibiotics. Conclusion: The study results show that most patients with VAP experienced leukocytosis (63.6%), and 84.8% had PCT concentrations > 0.5ng/ml. The majority of patients have damage to both lungs (69.7%). The rate of positive bronchial fluid culture was 72.7%. Acinetobacter baumannii and Pseudomonas aeruginosa were the most common pathogenic bacteria (40% and 36%). Acinetobacter baumanni, Pseudomonas aeruginosa, and Klebsiella pneumoniae have been identified as being resistant to empiric antibiotics, except for Colistin.