PDF(Pubmed)
Abstract：
Tracheostomy is a surgical procedure in an emergency setting to relieve the upper airway obstruction by creating an opening in the anterior part of trachea. It can also be done electively to wean off from a ventilator, during an elective surgery and clearance of pulmonary secretions. This study was a retrospective analysis of microbiological profile, antibiotic sensitivity & resistance pattern in patients with a tracheostomized wound. A retrospective review of the microbiological profiles of all adult patients who underwent a tracheostomy was conducted between May 2022 and May 2023 at our hospital. Based on the tracheostomy indications, patients were allocated under obstructed and non-obstructed group. Any patient with at least one positive sample was followed up quarterly for a year. The first culture result obtained was recorded at least one month following the last antibiotic dose in each quarter. Out of the 65 tracheal aspirate results obtained from 58 patients (mean age, 57.5 ± 16.48 years), the most common procedure and indications were surgical tracheostomy (72.4%) and non-obstructed causes (74.1%), respectively. Moreover, 47.7% of the culture results indicated Pseudomonas aeruginosa, which showed significantly different proportions across the quarters (p = 0.006). Among obstructed patients, P. aeruginosa was the most common (35%), followed by methicillin-resistant Staphylococcus aureus (MRSA; 23.5%). The colonization was predominantly by gram negative bacteria Acinetobacter species, P. aeruginosa & Klebsiella pneumoniae and fungal species like Candida albicans followed by Aspergillus niger and non-Albicans candida.
摘要：
气管造口术是在紧急情况下通过在气管前部形成开口来缓解上呼吸道阻塞的外科手术。也可以选择性地从呼吸机上断奶，在选择性手术和清除肺分泌物期间。这项研究是对微生物概况的回顾性分析，气管切开伤口患者的抗生素敏感性和耐药性模式。2022年5月至2023年5月在我们医院对所有接受气管造口术的成年患者的微生物学特征进行了回顾性审查。根据气管造口术的适应症,患者被分配到阻塞和非阻塞组.任何具有至少一个阳性样本的患者每季度随访一年。在每个季度的最后一次抗生素剂量后至少一个月记录获得的第一次培养结果。在从58例患者获得的65例气管抽吸结果中（平均年龄，57.5±16.48岁)，最常见的手术和适应症是外科气管切开术（72.4％）和非阻塞原因（74.1％），分别。此外，47.7%的培养结果提示铜绿假单胞菌,这表明各季度的比例显著不同(p=0.006)。在阻塞的病人中，铜绿假单胞菌是最常见的(35%)，其次是耐甲氧西林金黄色葡萄球菌(MRSA;23.5%)。定植主要由革兰氏阴性菌不动杆菌属，铜绿假单胞菌和肺炎克雷伯菌以及白色念珠菌等真菌，其次是黑曲霉和非白色念珠菌。
