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ORAL CAVITY COLONIZATION WITH MULTIDRUG-RESISTANT GRAM-NEGATIVE BACTERIA AFTER PREOPERATIVE PROPHYLACTIC USE OF ANTIBIOTICS AS A RISK FACTOR FOR VENTILATOR-ASSOCIATED PNEUMONIA
Vesna Bratić
; Department of Anaesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Anita Lukić
; Department of Anesthesiology, Reanimatology and Intensive Care Medicine, General Hospital Varaždin, Varaždin, Croatia
Branka Bedenić
; Department for Clinical and Molecular Microbiology, University Hospital Centre Zagreb, Zagreb, Croatia
Ivana Bjelanović
; Emergency Department, University Hospital Center, Mostar, Bosnia and Herzegovina
Mateo Bevanda
; Department of Surgery, University Hospital Center Mostar
Slobodan Mihaljević
; Department of Anaesthesiology, Reanimatology and Intensive Care Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Željko Verzak
; Department of Pediatric and Preventive Stomatology, University Hospital Centre Zagreb, Zagreb, Croatia
Sažetak
Background: Although it was previously shown that prolonged prophylactic antibiotic exposure and multiple inadequate antibiotic
therapies are independent risk factors for multidrug-resistant ventilator associated pneumonia there were no studies investigating
whether pre-operative prophylactic dose of antibiotics changes oral microbiome and increases the risk of ventilator associated
pneumonia. The aim of the study was to determine if pre-operative prophylactic dose of antibiotics affects the oral microbiome,
increases the colonization with Gram-negative bacteria and subsequent risk of ventilator associated pneumonia.
Subjects and methods: Mechanically ventilated adult patients receiving surgical antibiotic prophylaxis were included in the
study. The presence of Gram negative microorganisms in the pre-prophylactic and post-prophylactic oral swabs and tracheal
aspirates, as well as the occurrence of ventilator associated pneumonia, were analyzed.
Results: Number of patients colonized with Gram negative bacteria in post- prophylactic oral swab was significantly higher
compared to oral swab taken before prophylactic antibiotic. On the other hand, the number of patients with Gram- negative bacteria
in tracheal aspirates remained similar as in post- prophylactic oral swabs. Moreover, we found that presence of Gram- negative
bacteria in both pre- and post- prophylactic oral swabs was in the positive correlation with the presence of Gram- negative bacteria
in tracheal aspirates.
Conclusions: This study showed increased colonization of oral cavity with Gram- negative bacteria after preoperative
prophylactic antibiotics. Furthermore, receiving two prophylactic antibiotics from WHO Watch list increased the incidence of Gramnegative
bacteria in oral swabs and tracheal aspirates, and the risk of ventilator associated pneumonia development.
Ključne riječi
ventilator associated pneumonia; oral cavity colonization; multidrug-resistant gram-negative bacteria; antibiotic prophylaxis
Hrčak ID:
272947
URI
Datum izdavanja:
8.2.2022.
Posjeta: 302 *