EVALUATION OF TRACHEAL ASPIRATE CULTURES IN PATIENTS FOLLOWED WITH HOME MECHANICAL VENTILATORS

Abstract

Introduction: In recent years, there has been an increase in the use of mechanical ventilators at home. In this study, we aimed to investigate the underlying diseases, admission complaints, microorganisms that isolated in samples taken from tracheal aspirate (TA) cultures and their resistance to antibiotics in patients followed up with mechanical ventilators at home.
 Methods: Between January 1, 2020 and January 1, 2021, TA cultures, identification of bacteria and their antibiotic susceptibilities were evaluated by VITEK 2 (bioMeriux, France) automated identification system. The patients' age, gender, underlying diseases, duration of home ventilator use, complaints, and laboratory data were reviewed retrospectively from the patient files.
 Results: Of the 91 prediagnosed ventilator-associated pneumonia (VAP) patients examined in the study, 72 (79%) were male and 19 (21%) were female. The ages of the patients ranged from 5 to 212 month, with a mean age of 91,64 ± 64,07 month. The most common reason for referral was fever and dyspnea and 43.76% of the patients were diagnosed with cerebral palsy/epilepsy and 10.4% with syndromes.
 Of the samples; 12 (13.3%) were defined as Gram-positive and 79 (86.7%) as Gram-negative. Pseudomonas aeruginosa was detected in 44 (48.4%) samples, S. marcescens in 9 (9.9%) and Klebsiella in 8 (8.8%) samples. Staph aureus was detected in 12 (13.3%) samples. Carbapenem resistance was 18.75% for P. auriginosa, 16% for Klebsiella, 12.5 for E.coli and 12% for Acinetobacter baumani.
 Conclusion: TA culture should be taken from patients with home mechanic ventilator (HMV) who admitted with signs of infection such as fever and respiratory distress and treatment should be arranged according to the result. It was observed that the TA culture antibiotic resistance rates of the patients followed up with HMV at home was lower than the TA cultures sent from the patients hospitalized in the intensive care unit.