Microbiological profile of ventilator-associated pneumonia among intensive care unit patients in tertiary Egyptian
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Date
2020
Journal Title
Journal ISSN
Volume Title
Type
Article
Publisher
Journal of Infection in Developing Countries
Series Info
Journal of Infection in Developing Countries;Volume 14, Issue 2, 2020, Pages 153-161
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Abstract
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Introduction: Ventilator-associated pneumonia (VAP) is one of the common serious infectious diseases encountered in the intensive care unit (ICU), which highly affects the healthcare cost and patient prognosis. VAP is caused by various antimicrobial-resistant aetiological agents and the clinical manifestations lack sensitivity and specificity, making the prompt treatment is a challenge. This study aimed to investigate the microbial profile of VAP causing microorganisms among ICU patients in Egypt, antimicrobial susceptibility patterns and the genetic diversity among the frequently isolated organisms. Methodology: Throughout the period from August 2016 to August 2017, endotracheal aspirate (ETA) specimens were collected from ICU patients with clinically suspected VAP in two tertiary hospitals in Cairo. ETA specimens were investigated for the microbial content. The antimicrobial susceptibility was determined by the Kirby-Bauer method. ERIC-PCR was performed for genotyping. Results: Fifty microbiologically confirmed VAP cases were identified. The most frequently isolated microorganisms were Klebsiella spp., followed by Pseudomonas aeruginosa, Acinetobacter baumannii. Candida spp. was the most isolated fungi. A single isolate of each Cupriavidus pauculus and Aeromonas salmonicida was isolated. Antimicrobial susceptibility profiles indicated 40% of isolates were multidrug-resistant (MDR). ERIC-PCR revealed no genetic relatedness among K. pneumoniae isolates, the most frequently isolated microorganism. Conclusions: Gram-negative bacteria are the main causative agents of VAP cases, which mostly are MDR. Microorganisms like C. pauculus and A. salmonicida should be taken into consideration as VAP causative agents. There was no common source of infection suggesting likely endogenous sources of K. pneumoniae, the main causative agent of VAP in this study
Description
Scopus
Keywords
university of ERIC, Genotyping, ERICGenotypingIntensive care unit, Multidrug-resistant, Ventilator-Associated Pneumonia
Citation
Chittawatanarat, K., Jaipakdee, W., Chotirosniramit, N., Chandacham, K., Jirapongcharoenlap, T. Microbiology, resistance patterns, and risk factors of mortality in ventilator-associated bacterial pneumonia in a Northern Thai tertiary-care university based general surgical intensive care unit (Open Access) (2014) Infection and Drug Resistance, 7, pp. 203-210. Cited 30 times. http://www.dovepress.com/getfile.php?fileID=21223 doi: 10.2147/IDR.S67267 View at Publisher 2 Talha, K.A., Hasan, Z., Selina, F., Palash, M.I. Organisms associated with ventilator-associated pneumonia in intensive care unit (2009) Mymensingh Med J, 22, pp. 72-77. Cited 3 times. 3 Ali, S., Waheed, K., Iqbal, Z.H. MICROBIOLOGICAL PATTERN OF VENTILATOR ASSOCIATED PNEUMONIA (2015) Journal of Ayub Medical College, Abbottabad : JAMC, 27 (1), pp. 117-119. 4 Moreira, M.R., Gontijo Filho, P.P. Multidrug-resistant pathogens causing ventilator-associated pneumonia : Risk factors, empirical antimicrobial therapy and outcome of patients in an intensive care unit (ICU) of a Brazilian university hospital (2012) Int J Med Med Sci, 4, pp. 204-210. Cited 3 times. 5 Jampala, B.L., Toleti, S., Kolipaka, S.R., Myneni, R.B. A clinico-microbiological study in patients undergoing mechanical ventilation in a tertiary care hospital (2016) Int J Res Med Sci, 4, pp. 2856-2858. 6 Aravind, M., Navaneeth, B.V., Motagi, A. A study on device associated infections in the adult intensive care unit at a tertiary care hospital (2014) Int J Sci Res, 3, pp. 2319-7064. Cited 2 times. 7 Hashimoto, S., Shime, N. Evaluation of semi-quantitative scoring of Gram staining or semi-quantitative culture for the diagnosis of ventilator-associated pneumonia: A retrospective comparison with quantitative culture (Open Access) (2013) Journal of Intensive Care, 1 (1), art. no. 2. Cited 12 times. http://www.jintensivecare.com/ doi: 10.1186/2052-0492-1-2 View at Publisher 8 Cheesbrough, M. (2006) Medical Laboratory Manual for Tropical Countries (Part 2), 2nd Edition, p. 434. Cited 445 times. New York: Cambridge University Press 9 Bauer, A.W., Kirby, W.M., Sherris, J.C., Turck, M. Antibiotic susceptibility testing by a standardized single disk method. (1966) American Journal of Clinical Pathology, 45 (4), pp. 493-496. Cited 10734 times. View at Publisher 10 (2017) Performance Standards for Antimicrobial Susceptibility Testing, 29th Informational Supplement. Cited 76 times. Clinical and Laboratory standard institute (CLSI), CLSI document (M100-S29) 11 Abdulall, A.K., Tawfick, M.M., El Manakhly, A.R., El Kholy, A. Carbapenem-resistant Gram-negative bacteria associated with catheter-related bloodstream infections in three intensive care units in Egypt (2018) European Journal of Clinical Microbiology and Infectious Diseases, 37 (9), pp. 1647-1652. Cited 6 times. link.springer.de/link/service/journals/10096/index.htm doi: 10.1007/s10096-018-3294-7 View at Publisher 12 Mehta, A., Bhagat, R. Preventing Ventilator-Associated Infections (2016) Clinics in Chest Medicine, 37 (4), pp. 683-692. Cited 12 times. http://www.elsevier.com/inca/publications/store/6/2/3/3/5/6/index.htt doi: 10.1016/j.ccm.2016.07.008 View at Publisher 13 Mathai, A.S., Phillips, A., Kaur, P., Isaac, R. Incidence and attributable costs of ventilator-associated pneumonia (VAP) in a tertiary-level intensive care unit (ICU) in northern India (Open Access) (2015) Journal of Infection and Public Health, 8 (2), pp. 127-135. Cited 20 times. http://www.elsevier.com/wps/find/journaldescription.cws_home/716388/descriptio doi: 10.1016/j.jiph.2014.07.005 View at Publisher 14 Joseph, N.M., Sistla, S., Dutta, T.K., Badhe, A.S., Rasitha, D., Parija, S.C. Outcome of ventilator-associated pneumonia: Impact of antibiotic therapy and other factors (2012) Australasian Medical Journal, 5 (2), pp. 135-140. Cited 12 times. http://www.amj.net.au/index.php?journal=AMJ&page=article&op=view&path%5B%5D=1004&path%5B%5D=900 doi: 10.4066/AMJ.2012.1004 View at Publisher 15 Eida, M., Nasser, M., El-Maraghy, N., Azab, K. Pattern of hospital-acquired pneumonia in intensive care unit of Suez canal university hospital (2015) Egypt J Chest Dis Tuberc, 64, pp. 625-631. Cited 3 times. 16 Curcio, D., Castagnino, J., Vazquez, W., Vergara, G., Curiale, A. Tigecycline in the treatment of ventilator-associated pneumonia: Experience from the Latin American tigecycline use registry (2010) Infezioni in Medicina, 18 (1), pp. 27-34. Cited 11 times. www.infezmed.it 17 Rana, G., Sharma, S., Hans, C. Ventilator-associated pneumonia in the ICU : Microbiological Profile (2017) J Bacteriol Mycol, 4, pp. 165-168. 18 Djordjevic, Z.M., Folic, M.M., Jankovic, S.M. Distribution and antibiotic susceptibility of pathogens isolated from adults with hospital-acquired and ventilator-associated pneumonia in intensive care unit (Open Access) (2017) Journal of Infection and Public Health, 10 (6), pp. 740-744. Cited 11 times. http://www.elsevier.com/wps/find/journaldescription.cws_home/716388/descriptio doi: 10.1016/j.jiph.2016.11.016 View at Publisher 19 De Souza Kock, K., Maurici, R. Respiratory mechanics, ventilator-associated pneumonia and outcomes in intensive care unit (2018) World J Crit Care Med, 7, pp. 24-30. Cited 3 times. 20 Joseph, N.M., Sistla, S., Dutta, T.K., Badhe, A.S., Parija, S.C. Ventilator-associated pneumonia: Role of colonizers and value of routine endotracheal aspirate cultures (Open Access) (2010) International Journal of Infectious Diseases, 14 (8), pp. e723-e729. Cited 25 times. doi: 10.1016/j.ijid.2010.02.2248 View at Publisher 21 Pravin Charles, M.V., Easow, J.M., Joseph, N.M., Ravishankar, M., Kumar, S., Umadevi, S. Aetiological agents of ventilator-associated pneumonia and its resistance pattern - A threat for treatment (Open Access) (2013) Australasian Medical Journal, 6 (9), pp. 430-434. Cited 10 times. http://www.amj.net.au/index.php?journal=AMJ&page=article&op=viewFile&path[]=1710&path[]=1103 doi: 10.4066/AMJ.2013.1710 View at Publisher 22 Park, D.R. The microbiology of ventilator-associated pneumonia (2005) Respiratory Care, 50 (6), pp. 742-763. Cited 146 times. View at Publisher 23 Goel, V., Hogade, S.A., Karadesai, S.G. Ventilator associated pneumonia in a medical intensive care unit: Microbial aetiology, susceptibility patterns of isolated microorganisms and outcome (Open Access) (2012) Indian Journal of Anaesthesia, 56 (6), pp. 558-562. Cited 11 times. http://www.ijaweb.org/article.asp?issn=0019-5049;year=2012;volume=56;issue=6;spage=558;epage=562;aulast=Goel;type=2 doi: 10.4103/0019-5049.104575 View at Publisher 24 Golia, S., Sangeetha, K.T., Vasudha, C.L. Microbial profile of early and late onset ventilator associated pneumonia in the intensive care unit of a tertiary care hospital in Bangalore, India (Open Access) (2013) Journal of Clinical and Diagnostic Research, 7 (11), pp. 2462-2466. Cited 14 times. http://www.jcdr.net/articles/PDF/3580/13-%206344_E%28RT%29_F%28H%29_PFA%28P%29.pdf doi: 10.7860/JCDR/2013/6344.3580 View at Publisher 25 Llitjos, J.-F., Amara, M., Benzarti, A., Lacave, G., Bedos, J.-P., Pangon, B. Prior antimicrobial therapy duration influences causative pathogens identification in ventilator-associated pneumonia (2018) Journal of Critical Care, 43, pp. 375-377. Cited 3 times. http://www.elsevier.com/inca/publications/store/6/2/3/1/4/3/index.htt doi: 10.1016/j.jcrc.2017.10.027 View at Publisher 26 Samra, S.R., Sherif, D.M., Elokda, S.A. Impact of VAP bundle adherence among ventilated critically ill patients and its effectiveness in adult ICU (2017) Egypt J Chest Dis Tuberc, 66, pp. 81-86. Cited 6 times. 27 Chaudhury, A., Shobha Rani, A., Kalawat, U., Sumant, S., Verma, A., Venkataramana, B. Antibiotic resistance & pathogen profile in ventilator-associated pneumonia in a tertiary care hospital in India (Open Access) (2016) Indian Journal of Medical Research, 144 (September), pp. 440-446. Cited 5 times. http://www.icmr.nic.in/ijmr/2016/September/0916.pdf doi: 10.4103/0971-5916.198679 View at Publisher 28 Girish, N., Rajendran, R. Bacteriological profile of ventilator-associated pneumonia in a tertiary care hospital and their antibiotic resistance pattern (2015) Int J Med Microbiol Trop Dis, 314, pp. 1-5. Cited 2 times. 29 Mansour, M.G.E., Albendary, S. Multiplex polymerase chain reaction: Could change diagnosis of Ventilator-associated pneumonia in pediatric critical care units to the fast track? (Open Access) (2018) Egyptian Journal of Medical Human Genetics, 19 (2), pp. 135-139. http://www.sciencedirect.com/science/journal/11108630 doi: 10.1016/j.ejmhg.2017.08.012 View at Publisher 30 Azab, S.F.A., Sherbiny, H.S., Saleh, S.H., Elsaeed, W.F., Elshafiey, M.M., Siam, A.G., Arafa, M.A., (...), Gheith, T. Reducing ventilator-associated pneumonia in neonatal intensive care unit using "VAP prevention Bundle": A cohort study (Open Access) (2015) BMC Infectious Diseases, 15 (1), art. no. 314. Cited 23 times. http://www.biomedcentral.com/bmcinfectdis/ doi: 10.1186/s12879-015-1062-1 View at Publisher 31 Ahmed, W., Rana, M.N., Muzaffar, N.A., Abbassi, S. Microorganisms related with ventilator-associated pneumonia (VAP) and their antibiotic sensitivity pattern (2014) J Rawalpindi Med Coll, 18, pp. 45-48. Cited 3 times. 32 Almasy, E., Szederjesi, J., Rad, P., Georgescu, A. A fatal case of community acquired Cupriavidus pauculus pneumonia (2016) J Crit Care Med, 2, pp. 201-204. 33 Turković, T.M., Grginić, A.G., Cuculić, B.D., Gašpar, B., Širanović, M., Perić, M. Microbial profile and antibiotic susceptibility patterns of pathogens causing ventilator-associated pneumonia at Intensive Care Unit, Sestre milosrdnice University Hospital Center, Zagreb, Croatia (2015) Acta Clinica Croatica, 54 (2), pp. 127-135. Cited 4 times. http://hrcak.srce.hr/file/213930 34 da Silva Jr., J.M., Rezende, E., Guimarães, T., dos Campos, E.V., Magno, L.A., Consorti, L., Pereira, R.A.P., (...), Mendonça, J.S. Epidemiological and microbiological analysis of ventilator-associated pneumonia patients in a public teaching hospital (2007) Brazilian Journal of Infectious Diseases, 11 (5), pp. 482-488. Cited 15 times. http://www.scielo.br/pdf/bjid/v11n5/a09v11n5.pdf View at Publisher 35 Johnson, L.B., Bradley, S.F., Kauffman, C.A. Fungaemia due to Cryptococcus laurentii and a review of non-neoformans cryptococcaemia (1998) Mycoses, 41 (7-8), pp. 277-280. Cited 58 times. http://www.wiley.com/bw/journal.asp?ref=0933-7407 doi: 10.1111/j.1439-0507.1998.tb00338.x View at Publisher 36 Smith, N., Sehring, M., Chambers, J., Patel, P. Perspectives on non-neoformans cryptococcal opportunistic infections (2017) J Community Hosp Intern Med Perspect, 7, pp. 214-217. Cited 12 times. 37 Shankar, E.M., Kumarasamy, N., Bella, D., Renuka, S., Kownhar, H., Suniti, S., Rajan, R., (...), Rao, U.A. Pneumonia and pleural effusion due to Cryptococcus laurentii in a clinically proven case of AIDS (Open Access) (2006) Canadian Respiratory Journal, 13 (5), pp. 275-278. Cited 27 times. http://www.hindawi.com/journals/crj/ doi: 10.1155/2006/160451 View at Publisher 38 Meacham, K.J., Zhang, L., Foxman, B., Bauer, R.J., Marrs, C.F. Evaluation of Genotyping Large Numbers of Escherichia coli Isolates by Enterobacterial Repetitive Intergenic Consensus-PCR (Open Access) (2003) Journal of Clinical Microbiology, 41 (11), pp. 5224-5226. Cited 43 times. doi: 10.1128/JCM.41.11.5224-5226.2003 View at Publisher 39 Karagözoǧlu, S., Yildiz, F.T., Gürsoy, S., Gülsoy, Z., Süha, B.K., Koçyiǧit, H., Elaldi, N., (...), Arslan, G. The effect of bundle adaptation control on vap speed and length of hospital stay in avoiding the ventilator associated pneumonia (VAP) at Anesthesia Intensive Care Unit (2018) Int J Nurs Clin Pract, 5, pp. 295-301. 40 Heo, S.-M., Haase, E.M., Lesse, A.J., Gill, S.R., Scannapieco, F.A. Genetic relationships between respiratory pathogens isolated from dental plaque and bronchoalveolar lavage fluid from patients in the intensive care unit undergoing mechanical ventilation (Open Access) (2008) Clinical Infectious Diseases, 47 (12), pp. 1562-1570. Cited 92 times. doi: 10.1086/593193 View at Publisher