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Braz. j. infect. dis ; 20(5): 468-475, Sept.-Oct. 2016. tab, graf
Article Dans Anglais | LILACS | ID: biblio-828141

Résumé

Abstract Objectives To compare cultured microorganisms identified on endotracheal tubes biofilms through sonication technique with traditional tracheal aspirate collected at extubation of pediatric intensive care unit patients. Methods Demographic and epidemiological data were analyzed to identify factors possibly related with the microbiological profile of the two collection methods. Associations between categorical and continuous variables were analyzed using the chi-square or Fisher's exact test, or Student's t test. p-Value <0.05 were considered significant. Results Thirty endotracheal tubes and tracheal aspirates samples from 27 subjects were analyzed. Only one patient presented the clinical diagnosis of ventilator-associated pneumonia. Overall, 50% of bacteria were Gram-negative bacilli, followed by Gram-positive bacteria in 37%, and fungi in 10%. No statistically significant difference on the distribution of Gram-positive or Gram-negative bacteria (p = 0.996), and fungi (p = 0.985) were observed between the collection methods. Pseudomonas spp. was the most frequent microorganism identified (23.8%), followed by Streptococcus spp. (18.5%), Acinetobacter spp. (15.9%), coagulase-negative staphylococci (11.2%), and Klebsiella spp. (8.6%). Concordant results between methods amounted to 83.3%. Pseudomonas aeruginosa and Acinetobacter baumannii showed carbapenem resistance in 50% and 43.7% of the isolates, respectively. In general, cultures after endotracheal tubes sonication (non-centrifuged sonication fluid and centrifuged sonication fluid) yielded bacteria with higher rates of antimicrobial resistance compared to tracheal aspirates cultures. Additionally, in 12 subjects (40%), we observed discrepancies regarding microbiologic profiles of cultures performed using the collection methods. Conclusions Our study demonstrated that sonication technique can be applied to ET biofilms to identify microorganisms attached to their surface with a great variety of species identified. However, we did not find significant differences in comparison with the traditional tracheal aspirate culture approach.


Sujets)
Humains , Mâle , Femelle , Nourrisson , Enfant d'âge préscolaire , Enfant , Sonication/méthodes , Unités de soins intensifs pédiatriques/statistiques et données numériques , Biofilms/croissance et développement , Équipement et fournitures hospitaliers/microbiologie , Intubation trachéale/instrumentation , Valeurs de référence , Facteurs temps , Trachée/microbiologie , Numération de colonies microbiennes , Tests de sensibilité microbienne , Contamination de matériel/statistiques et données numériques , Reproductibilité des résultats , Pneumopathie infectieuse sous ventilation assistée/microbiologie , Champignons/isolement et purification , Bactéries à Gram négatif/isolement et purification , Bactéries à Gram positif/isolement et purification , Durée du séjour , Antibactériens/usage thérapeutique
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