Problem of efficiency of antibiotic prophylaxis ventilator-associated pneumonia in newborns
The presence of the endotracheal intubation tube (EIT) in the respiratory tract is a factor contributing to the development of the VAP. The formation of biofilms on the surface of the ЕІТ is a significant factor in the pathogenesis of ventilator-associated infections of the lower respiratory tract. The purpose was to study the biological properties of the microflora of the endotracheal tubes of newborns, determining the sensitivity of planktonic and film forms of microorganisms to antibiotics. 18 intubation tubes were examined. Gram-negative bacteria (77%) were the leaders among contaminants. From tubes of newborns there were isolated K.pneumoniae isolated (36%), E.сloacae (23%). The surface of the intubation in 9% of cases tubes was colonized Pseudomonas and Stenotrophomonas, were insensitive to carbapenems, rifampicin, cephalosporins III and IV generations. P. aeruginosa has not shown sensitivity to cefoperazone/sulbactam, fluoroquinolones. There were sensitive 100% of strains P.aeruginosa to polymyxin. Stanotrophomonas were sensitive to fluoroquinolones in 100% of cases. Sensitivity of the K.pneumoniae to carbapenems and cefoperazone/sulbactam was determined in 50–58% of strains. E.cloacae strains demonstrated sensitivity to carbapenems in 100% of cases, and sensitivity to protected cephalosporins was 83%. Cefepim, meropenem, amikacin do not completely eliminate the viable cells of Stenotrophomonas, Klebsiella and Enterobacter cells from the biofilms, even under the maintenance of such a concentration during 4 days. Only viable cells of Pseudomonas in biofilms that were present in the solution of amikacin for more than a twenty-four hours were not detected. The low level of sensitivity of microorganisms colonizing endotracheal tubes to the majority of modern antibiotics and the complexity of exposure to biofilm forms of bacteria lead to complex large-scale studies and the introduction, based on their results, of protocols for treatment and prevention of infections.
2. Choudhury, A. M., Nargis, S., Mollah, A. H., Kabir, L. M. & Sarkar, R. N. (2010). Determination of risk factors of neonatal pneumonia. Mymensingh Med. J., 19 (3), 323‒329. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/20639820.
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