KHẢO SÁT TÌNH HÌNH NHIỄM KHUẨN VÀ THỜI GIAN ĐIỀU TRỊ TRONG NHIỄM TRÙNG CỔ SÂU TẠI BỆNH VIỆN CHỢ RẪY NĂM 2021- 2022

Abstract

Background: Choosing an appropriate initial antibiotic therapy for deep neck infection depends on bacteriology and antibiotic sensitivity pattern of pathogens. Length of stay reflects the severity of deep neck infection and the effectiveness of treatment. Objectives: Investigating bacteriology and length of stay in patients with deep neck infection in Cho Ray hospital from 12/2021 to 05/2022. Methods: Description of 138 patients with deep neck infection in Cho Ray hospital from 12/2021 to 05/2022. Results: Streptococcus sp. were the most common gram- positive bacterial pathogen (54%) and were sensitive 100% to Tigecycline, Linezolide, Vancomycin. Streptococcus anginosus group and other subgroups of Viridans Streptococci group were not sensitive to Penicillin (21.6% and 46.2%), Ceftriaxone (2.9% and 7.7%). K. pneumoniae were the most common gram- negative bacterial pathogen (29%), predominated in patients with diabetes (37.5% vs 13,9%; p <0,05); were highly sensitive to β-lactam/ β- lactamase inhibitors, Carbapenem, Tigecycline (89.7%- 93.1%). Multidrug-resistant organisms accounted for 20% and were various in species and phenotypes. The median of length of stay in patients with deep neck infection was 8 days, the interquartile range was 6-12 days, and the range was 2-36 days. Risk factors for length of stay ≥ 10 days included: number of involved spaces (OR = 1.42; 95% CI = 1.13 - 1.79), ketoacidosis (OR = 2.96; 95% CI = 1.12-7.82), prolonged purulent wound (OR = 5.9; 95% CI = 2.26-15.41). Conclusions: In deep neck infection, Streptococcus sp. were sensitive to Tigecycline, Linezolide, Vancomycin; not sensitive to Penicillin, Ceftriaxone. K. pneumoniae were sensitive to β-lactam/ β- lactamase inhibitors, Carbapenem, Tigecycline. Multidrug-resistant organisms were various. Number of involved spaces, ketoacidosis and prolonged purulent wound were risk factors for length of stay ≥ 10 days.