بررسي وضعيت كلونيزاسيون داخل تراشه بيماران انتوبه بستري در بخش ICU مسمومين بيمارستان لقمان حكيم تهران سال 1384

Bacterial endotracheal tube colonization in intubated patients in poisoning ICU ward of Loghman Hakim hospital of Tehran in 2005

Background and Aim:VentiIated_associated pneumonia is the most common acquired infection in ICU. The prevalence of pneumonia in intubated patients is 21 times more than other patients .Tracheal tube colonization is considered as a risk factor and affected with duration of intubation and decreased gastric acid. This study is conducted to determine the epidemiology and microbiology status in the patients admitted at loqman hospital poisoning ICU. Materials and Methods: The reaserch method was descriptive and itʹs technique was an observation-interview. Patients with positive endotracheal tube culture were entered the study, the sampling method was endotracheal aspiration. Qualitative culture and resistance pattern evaluation with Kirby-bauer method was used. We surveyed 180 intubated patients with mean age of 3t.63±13.9 years old .83.3 precent of the patients had recieved antibiotic therapy before sampling. Results: Staph, coag. positive,(45.6%)was the most commonly isolated pathogen and followed by Klebsiella, Acintobacter and E.coli. Isolation of one organism was seen in 62.8% and multiorganisms in 37.2%. Temp>38 was seen in one_third of the patients and WBC> 12000 was detected in 44 precents of the patients. There was a significant relationship between antibiotic therapy with fever. 11.1 precent of the patients died. There was a significant relationship between the kind of organism and survival ,but there was a significant relationship between antibiotic therapy before sampling and patientʹs survival. Conclusion:Detection of Acintobacter with Klebsiella , E.coli and Staph, aureuse increases the probability of nosocomial pneumonia caused by AST III group. Lack of relationship between kind of organism and prior antibiotic therapy is considered as an alarm for resistant infections.