CĂN NGUYÊN VI SINH GÂY NHIỄM TRÙNG HÔ HẤP Ở BỆNH NHÂN ĐỢT CẤP BỆNH PHỔI TẮC NGHẼN MẠN TÍNH THỜI ĐIỂM VÀO TRUNG TÂM HỒI SỨC TÍCH CỰC BỆNH VIỆN BẠCH MAI GIAI ĐOẠN 2023-2024

Abstract

Background: Acute  exacerbations  of  chronic  obstructive  pulmonary  disease (COPD) patients  who needed mechanical ventilation have a mortality rate of 40%. 80% of these exacerbations was caused by  infections,  with  at  least  40-50%  bacterial  infections. Identifying the microbiological etiology is crucial and clinically significant for selecting initial antibiotic therapy. Research objectives: 1. To identify the microbial causes of respiratory infections in patients with COPD at the Intensive Care Unit (ICU) of Bach Mai Hospital during the 2023-2024 period. 2. To determine the antibiotic sensitivity of the isolated bacteria and evaluate treatment outcomes. Subjects and Methods: A prospective descriptive study was conducted on 50 patients diagnosed with COPD who required antibiotic therapy at the ICU of Bach Mai Hospital from August 2023 to July 2024. Results: Among the 50 COPD patients requiring antibiotics, 60% had positive cultures. The most common bacterial pathogen was A. baumannii (33.3%), which was multidrug-resistant and intermediately sensitive to Colistin; K.pneumoniae (16.7%) remained sensitive to Carbapenems, Amikacin, Levofloxacin, Fosfomycin and Colistin; P. aeruginosa (13.3%) and E. coli (10%) were still sensitive to several antibiotics. The fungal pathogen Aspergillus fumigatus (20%) was sensitive to Voriconazole. Conclusion: Bacterial pathogens accounted for 48% of the exacerbations of COPD at the time of ICU admission. The isolated bacteria were predominantly gram-negative organisms responsible for hospital-acquired pneumonia and ventilator-associated pneumonia, with A. baumannii (33.3%) being the most common, followed by K. pneumoniae, P. aeruginosa, and E. coli. Acute exacerbations of COPD also carry a high risk of Aspergillus infections.