Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Research Article Volume 7 Issue 4

Respiratory Tract Infections in Trauma Patients in General Profile Intensive Care Units

Anatolii I Sukhodolia and Kostiantyn Yu Krenov*

National Pirogov Memorial Medical University, Bogomoletz Institute of Physiology of the National Academy of Medical Sciences of Ukraine, Khmelnytskyi Regional Hospital Municipal Non-Profit Enterprise of Khmelnytskyi Regional Council, Ukraine

*Corresponding Author: Kostiantyn Yu Krenov, National Pirogov Memorial Medical University, Bogomoletz Institute of Physiology of the National Academy of Medical Sciences of Ukraine, Khmelnytskyi Regional Hospital Municipal Non-Profit Enterprise of Khmelnytskyi Regional Council, Ukraine.

Received: March 25, 2024; Published: March 29, 2024

Abstract

Introduction: Respiratory tract infections, such as purulent endobronchitis and healthcare-associated pneumonia, including ventilator-associated pneumonia (VAP), remain a relevant issue in the ICU. Infections with multidrug-resistant pathogens, particularly ESBL and carbapenemase producers, complicate the selection of appropriate antibiotic therapy, and inhalation of antibacterial agents remains a method of questionable efficacy. The updated classification of ventilator-associated conditions, including VAP, and assessment with the CPIS scale are intended to simplify diagnosis and guide healthcare professionals to actively identify these conditions. Despite some progress, respiratory tract infections remain a serious, life-threatening complication with a high mortality rate.

Materials and Methods: An analysis of medical records of inpatients treated in the Department of Anesthesiology and Intensive Care of Khmelnytskyi Regional Hospital Municipal Non-Profit Enterprise of Khmelnytskyi Regional Council, Ukraine, who required mechanical ventilation for more than 48 hours during the period 2021-2023 was conducted.

Conclusion: A high percentage of multidrug-resistant Gram-negative flora, mainly ESCAPE group microorganisms such as A. baumannii, Kl. pneumoniae and Ps. aeruginosa, continue to be isolated from sputum. The susceptibility of these pathogens to carbapenems, aminoglycosides, Cefoperazone/Sulbactam has decreased. The diagnosis of ventilator-associated pneumonia in general intensive care units remains extremely low. The use of a standardized approach to the diagnosis and antibacterial therapy of respiratory tract infections is beneficial.

Keywords: Ventilator-Associated Pneumonia; Bronchoalveolar Lavage (BAL); Escape

References

  1. Afshari., et al. “Year in review 2011: Critical Care-infection”. Critical Care 16 (2012): 242.
  2. Bassetti Matteoa., et al. “Treatment of extended-spectrum β-lactamases infections: what is the current role of new β-lactams/β-lactamase inhibitors?” Current Opinion in Infectious Diseases6 (2020): 474-481.
  3. Burillo Almudena., et al. “Risk stratification for multidrug-resistant Gram-negative infections in ICU patients”. Current Opinion in Infectious Diseases6 (2019): 626-637.
  4. Christina Wacker., et al. “Procalcitonin as a diagnostic marker for sepsis: a systematic review and meta-analysis”. The Lancet Infectious Diseases 5 (2013): 426-435.
  5. Elin Helset., et al. “Meropenem pharmacokinetic/pharmacodynamic target attainment and clinical response in ICU patients: A prospective observational study”. Acta Anaesthesiologica Scandinavica 68 (2024): 502-511.
  6. Elizabeth W Covington., et al. “Procalcitonin Monitoring as a Guide for Antimicrobial Therapy: A Review of Current Literature”. Pharmacotherapy5 (2018): 569-581.
  7. Evans L., et al. “Surviving sepsis campaign: international guidelines for management of sepsis and septic shock. 2021”. Intensive Care Medicine 11 (2021): 1181-1247.
  8. Gowri Raman., et al. “Risk factors for hospitalized patients with resistant or multidrug-resistant Pseudomonas aeruginosa infections: a systematic review and meta-analysis”. Meta-Analysis Antimicrobial Resistance and Infection Control 7 (2018):79.
  9. Haifeng Hou., et al. “Predictive values of the SOFA score and procalcitonin for septic shock after percutaneous nephrolithotomy”. Urolithiasis6 (2022): 729-735.
  10. Ilja Areskog Lejbman., et al. “Beta-lactam antibiotic concentrations in critically ill patients with standard and adjusted dosages: A prospective observational study”. Acta Anaesthesiologica Scandinavica 68 (2024): 530-537.
  11. Kalil AC., et al. “Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society”. Clinical Infectious Diseases 5 (2016): e61-e111.
  12. Laurent Papazian., et al. “Ventilator‑associated pneumonia in adults a narrative review”. Intensive Care Med 46 (2020): 888-906.
  13. Leone M., et al. “Brief summary of French guidelines for the prevention, diagnosis and treatment of hospital-acquired pneumonia in ICU”. Annals of Intensive Care 8 (2018): 104.
  14. Maragakis Lisa L. “Recognition and prevention of multidrug-resistant Gram-negative bacteria in the intensive care unit”. Critical Care Medicine8 (2010): S345-S351.
  15. Pedro Póvoa., et al. “How to use biomarkers of infection or sepsis at the bedside: guide to clinicians”. Intensive Care Medicine 49 (2023):142-153.
  16. Perner A., et al. “Sepsis: frontiers in diagnosis, resuscitation and antibiotic therapy”. Intensive Care Medicine 12 (2016):1958-1969.
  17. Povoa P., et al. “Biomarker kinetics in the prediction of VAP diagnosis: results from the BioVAP study”. Annals of Intensive Care 6 (2016):32.
  18. Raimunda Xavier AlecrimI and Mônica TaminatoI. “Strategies for preventing ventilator-associated pneumonia: an integrative review”. Revista Brasileira de Enfermagem2 (2019):521-530.
  19. Ramon Sager., et al. “Procalcitonin-guided diagnosis and antibiotic stewardship revisited”. BMC Medicine 1 (2017):15.
  20. Rello J., et al. “Use of Nebulized. Antimicrobials for the Treatment of Respiratory Infections in Invasively Mechanically Ventilated Adults: A Position Paper from the European Society of Clinical Microbiology and Infectious Diseases”. Clinical Microbiology and Infection (2017).
  21. Sedat Ozbay., et al. “Diagnostic and Prognostic Roles of Procalcitonin and Other Tools in Community-Acquired Pneumonia: A Narrative Review”. Diagnostics 11 (2023): 1869.
  22. Torres., et al. “Guidelines for the management of hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) of the European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Asociación Latinoamericana del Tórax (ALAT)”. European Respiratory Journal 50 (2017): 1700582.
  23. Vincent JL., et al. “Prevalence and outcomes of infection among patients in intensive care units in 2017”. JAMA15 (2020): 1478-1487.
  24. Yuting Zhu., et al. “Monitoring Multidrug-Resistant Acinetobacter baumannii Infections in the Neurosurgery ICU Using a Real-Time Surveillance System”. Polish Journal of Microbiology 1 (2022): 107-114.

Citation

Citation: Anatolii I Sukhodolia and Kostiantyn Yu Krenov. “Respiratory Tract Infections in Trauma Patients in General Profile Intensive Care Units". Acta Scientific Gastrointestinal Disorders 7.4 (2024): 22-26.

Copyright

Copyright: © 2024 Anatolii I Sukhodolia and Kostiantyn Yu Krenov. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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