ĐẶC ĐIỂM LÂM SÀNG, VI SINH VÀ ĐIỀU TRỊ VIÊM PHỔI BỆNH VIỆN TẠI BỆNH VIỆN NHI ĐỒNG 2 NĂM 2022-2023

Abstract

Objectives: To describe clinical, microbiological, and treatment characteristics of hospital-acquired pneumonia (HAP) in children aged 1 months to 15 years old at Children's Hospital No2 from October 2022 to September 2023. Methods: case series. Results: During the period from October 1^st, 2022 to September 30^th, 2023, there were 30 children diagnosed HAP and included in the study. The mean age was 6.3 ± 2.5 months, and the male: female ratio was 1.2:1. Children under 12 months old accounted for 71.3%, malnutrition 45.1%. The increased or new cough, tachypnea, contraction of accessory respiratory muscles, and pulmonary rales were seen in all patients. Fever accounted for 95.7%. The average time of diagnosis of HAP was 8.3±3.1 (6-15) days after hospitalization. All were late HAP with respiratory failure, including grade 1 (26,6%), grade 2 (36,7%), and grade 3 (36.7%). The culture rate of positive nasal tracheal aspiration (NTA) was 36.7%. The most common pathogens isolated were Stenotrophomonas maltophilia (27.5%), Acinetobacter baumannii (24.1%), Klebsiella pneumoniae (24,1%) and Streptococcus pneumoniae (24,1%). The most commonly used antibiotics were Carbapenem 80% and Vancomycin 60%. There were 73.4% of children received respiratory support. The average duration of respiratory support was 17 ± 5.1 days. The median length of hospital stay was 32 (12-75) days. The mortality rate was 6.7%. Conclusions: The most common bacterial agents causing HAP were Stenotrophomonas maltophilia, Acinetobacter baumannii, Klebsiella pneumoniae, and Streptococcus pneumoniae. It is necessary to use initial antibiotics appropriately to the antibiotic resistance of the bacteria causing HAP to improve treatment results.