ABSTRACT
OBJECTIVE To investigate the risk factors of fungal ventilator associated pneumonia(FVAP) and the characteristic of pathogenic fungi.METHODS Thirty seven VAP patients were divided into FVAP group and nonfungal ventilator associated pneumonia(NFVAP) group.Risk factors were compared between the two groups and the characteristic of pathogenic fungi was analyzed.RESULTS Compared to the NFVAP group,the FVAP group showed a significant higher rate in systemic usage of glucocorticosteriod and combined application of antibiotics.The cases of FVAP appeared frequently over the period since 7th to 14th days after intubation.Twelve strains of fungi were isolated from the sputum of patients in FVAP group.Ten strains(83.3%) of the isolates belonged to Candida species included(C.albicans 6 strains(50.0%),C.tropicalis 2 strains(16.7%),C.krusei 1 strain(8.3%),and C.parapsilosis 1 strain(8.3%),and 2 strains(16.7%) of the isolates belonged to Aspergillus.CONCLUSIONS The rate of tracheal intubation should be decreased and the time of mechanical ventilation should be shortened to avoid FVAP.Identifying the strains of fungi and their sensitivity are useful to direct the treatment.
ABSTRACT
OBJECTIVE To approach to the point of clinical diagnosis and treatment in patients with Chryseobacterium meningosepticum(CM) infection,and test the high sensitivey antibiotic in order to provide evidence for clinical rational drug utilization.METHODS We had retrospectively analyzed the 36 clinical infections with CM during 2003.A microdilution broth method was used to detect the C.meningosepticum MIC and metallo-?-(lactamases-)production.RESULTS C.meningosepticum infections related to the critical underlying diseases,old age,stay in hospital,nosocomial infections and broad spectrum antibiotics use.Metallo-?-lactamases-producing accounted for 100% in all CM isolates.CM were susceptible or partly susceptible to VAN,CTX/CA,PIP/SU,CFP/SU,PIP,CIA,PIP which were 100%,100%,91.7%,88.9%,86.1%,72.2%,and 44.4%,respectively.The(susceptibility) to other 21 kinds of antimicrobials were in 8.3%.CONCLUSIONS CM is multi-drug resistant.The main risk factors of CM infection are old age,long-term in hospital,critical underlying disease,and decreased immunological function.VAN,CTX/CA,PIP/SU, CFP/SU,PIP,CIA,and PIP are the effective antibiotics(against) CM.