Etiology of hospital-acquired pneumonia in patients with complicated cervical spine injury. A retrospective study

Abstract

Objective. To study the etiological structure and antimicrobial resistance of hospital-acquired pneumonia pathogens in patients with complicated cervical spine injury. Materials and methods. A retrospective study included 418 bacterial isolates from sputum in 29 patients with hospital-acquired pneumonia who were treated in ICU during the period 2012–2013 and 2017–2018. Results. The most common pathogens from the lower respiratory tract, both in 2012–2013 and in 2017–2018 were Pseudomonas аeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae. The share of K. pneumoniae in 2017–2018 increased by 16.8 % (3.2 times more often), and the share of microorganisms of the Enterobacteriaceae — by 26.7 % (р < 0.001). The dynamic’s analysis shows an increase in the resistance of hospital gram-negative pathogens of hospital-acquired pneumonia to the main antimicrobial classes and an increase of the frequency of extremely resistant pathogens in 2017–2018 P. aeruginosa by 19.9 % (р = 0.008), A. baumannii by 13.8 % (р = 0.189), K. pneumoniae by 66.7 % (р < 0.001). Conclusion. Gram-negative microorganisms are the leading pathogens of hospital-acquired pneumonia in patients with complicated cervical spine injury. An increase of the level of antibiotic resistance creates an unfavorable background regarding the effectiveness of antimicrobial therapy for hospital-acquired pneumonia in patients with a complicated cervical spine injury.