RESEARCH ON THE MICROBIOLOGICAL CHARACTERISTICS, ANTIBIOTIC RESISTANCE STATUS, AND ANALYSIS OF RELATED FACTORS OF ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MECHANICAL VENTILATION AT CAN THO CENTRAL GENERAL HOSPITAL FROM 2023 TO 2024
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Abstract
Background: Most patients with acute exacerbation of chronic obstructive pulmonary disease require mechanical ventilation at a high mortality rate. Bacteria are the most common pathogens, with an increasing rate of antibiotic resistance. Objectives: To describe microbiology, antibiotic resistance, treatment outcome and related factors of exacerbation of chronic obstructive pulmonary disease patients with mechanical ventilation. Materials and methods: Prospective descriptive study of 62 acute exacerbations of chronic obstructive pulmonary disease patients with mechanical ventilations at Can Tho Centreal General Hospital from 2023 to 2024. Results: Most are 65 years old, male. The positive was including: Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli. There were 16 cases of Acinetobacter baumannii infection, with a 100% resistance rate to imipenem/meropenem. Pseudomonas aeruginosa had 2 cases, both showing 100% resistance to piperacillin/tazobactam. There were 3 cases of Klebsiella pneumoniae infection, mainly resistant to imipenem and levofloxacin. Regarding Escherichia coli, it was mainly resistant to ceftazidime (75%). There was a relationship between treatment outcome and age, smoking history and CRP value at admission. Patients with a history of >2 exacerbations/year had a higher mortality rate with OR (95% CI) of 4.641, p=0.023. Conclusions: The main causative agent encountered in acute exacerbations in chronic obstructive pulmonary disease requiring mechanical ventilation is Acinetobacter baumannii, which has a high rate of multidrug resistance, leading to a high mortality rate in treatment outcomes. Factors such as age, smoking history, CRP levels upon admission, and the number of exacerbations in a year are associated with treatment outcomes in patients.
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Keywords
Chronic obstructive pulmonary disease, mechanical ventilation, antibiotic resistance, associated factors
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