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

RESUMO

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.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Sonicação/métodos , Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos , Biofilmes/crescimento & desenvolvimento , Equipamentos e Provisões Hospitalares/microbiologia , Intubação Intratraqueal/instrumentação , Valores de Referência , Fatores de Tempo , Traqueia/microbiologia , Contagem de Colônia Microbiana , Testes de Sensibilidade Microbiana , Contaminação de Equipamentos/estatística & dados numéricos , Reprodutibilidade dos Testes , Pneumonia Associada à Ventilação Mecânica/microbiologia , Fungos/isolamento & purificação , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Tempo de Internação , Antibacterianos/uso terapêutico
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