Respiratory tract infections in trauma patients in general profile intensive care units

Abstract

Respiratory tract infections, such as purulent endobronchitis and healthcare-associated pneumonia, including ventilator-associated pneumonia (VAP), remain a relevant issue in the ICU. Infections with multidrug-resistant pathogens, particularly ESBL and carbapenemase producers, complicate the selection of appropriate antibiotic therapy, and inhalation of antibacterial agents remains a method of questionable efficacy. The updated classification of ventilator-associated conditions, including VAP, and assessment with the CPIS scale are intended to simplify diagnosis and guide healthcare professionals to actively identify these conditions. Despite some progress, respiratory tract infections remain a serious, life-threatening complication with a high mortality rate. Materials and Methods: An analysis of medical records of inpatients treated in the Department of Anesthesiology and Intensive Care of Khmelnytskyi Regional Hospital Municipal Non-Profit Enterprise of Khmelnytskyi Regional Council, Ukraine, who required mechanical ventilation for more than 48 hours during the period 2021-2023 was conducted. Conclusion: A high percentage of multidrug-resistant Gram-negative flora, mainly ESCAPE group microorganisms such as A. baumannii, Kl. pneumoniae and Ps. aeruginosa, continue to be isolated from sputum. The susceptibility of these pathogens to carbapenems, aminoglycosides, Cefoperazone/Sulbactam has decreased. The diagnosis of ventilator-associated pneumonia in general intensive care units remains extremely low. The use of a standardized approach to the diagnosis and antibacterial therapy of respiratory tract infections is beneficial.