Borysova, Inna

Naumenko, Leonid

Perceva, Tetyana

Stepanskiy, Dmitriy

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Abstract Submission27. Infectious diseases, supportive careEHA-1113NOSOCOMIAL PNEUMONIA HEMATOLOGIC PATIENTS CAUSED BY P.AEROGINOSA: THE PROBLEM OFRATIONAL ANTIBACTERIAL THERAPYTetyana Perceva1, Inna Borysova* 2, Leonid Naumenko2, Dmitriy Stepanskiy31 Department of Internal Medicine , 2Department of Medical-Social Expertise and Rehabilitation, 3Department ofMicrobiology, Virology, Immunology and Epidemiology, SE “Dnipropetrovsk Medical Academy of Health Ministry ofUkraine”, Dnipropetrovsk, UkraineBackground: The treatment of pneumonia in patients on the background of oncological blood diseases is not a simpleclinical task in hematology hospitals. Special problem is the diseases of the lower respiratory tract caused byP.аeruginosa that requires learning of the local sensitivity of microorganisms to antibacterial preparations.Aims:  To investigate the frequency and determine the status of resistance of isolates of P. aeruginosa  in patients with in-hospital pneumonia with severe disorders of immunity on the background of hematologic diseases to develop a rationalstrategy and tactics of empirical antibiotic therapy.Methods: Studied 249 patients with pneumonia on a background of severe immune disorders, which during 2011-2013on the basis of KU "Dnipropetrovsk city multi-field clinical hospital No. 4 DOR" passed hospital treatment is consistentwith the stage and nosology of hematologic disease. The age of patients ranged from 34 to 76 years. The diagnosis ofoncohematological diseases defined in accordance with the generally accepted morphological and cytological,immunological and cytogenetic (for myeloid leukemia) studies of bone marrow transplantation, division of acute leukemiawas carried out according to FAB classification. The diagnosis of pneumonia was determined in accordance withgenerally accepted clinical manifestations.Materiales for the identification of possible causative agents of pneumonia were sputum and the bronchoalveolar lavageliquid. Microbiology was conducted by examining native smears with the identification of the main morphological types indense  and  differential  nutrient  media.  Susceptibility  of  isolates  to  antibiotics  was  conducted  disk  diffusion  methodaccording  to  the  recommendations  of  EARSS.  Statistical  processing  of  the  obtained  results  with  standard  functionpackage “MS Exel”.Results: Only 37,3% of patients at the study succeeded identify possible bacterial agents of pneumonia in etiologicallysignificant concentration. In 53.6% of patients in the study group bacterial pathogens was not possible to determine. At9.0% was possible to identify bacterial pathogens at concentrations of the poor for diagnostically significant. These caseswere patients who before clinical and radiological signs of pneumonia received antibiotic therapy due to febrileneutropenia, and in the way they determine the etiological diagnosis.  Summary/Conclusion: According to the results of microbiological investigations of patients of group study identifiedintensive circulation of various bacterial pathogens of pneumonia with the rapid formation of hospital strains. Among thepositive results of microbiological studies were the leading gram-negative strains P. aeroginosа  that was 23.7% of thestudies. The results of the research, determine the status of resistance of local strains of P.aeroginosа been proven highclinical efficacy of Meronem, amikacin, cefepime, kolestin, which should be used in the individual schemes ofantibacterial therapy in patients in the Hematology hospitals for the treatment of pneumonia.Keywords: Hematological malignancy, Pulmonary, Treatment

Nosocomial Pneumonia Hematologic Patients Caused by Р.Aeroginosa: the Problem of Rational Antibacterial Therapy. Нозокомиальные пневмонии у гематологических больных: внимание на Р. Аеroginosa.

http://repo.dma.dp.ua/806/1/EHA-1113-preview-3.pdf

Nosocomial Pneumonia Hematologic Patients Caused by Р.Aeroginosa: the Problem of Rational Antibacterial Therapy. Нозокомиальные пневмонии у гематологических больных: внимание на Р. Аеroginosa.

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Nosocomial Pneumonia Hematologic Patients Caused by Р.Aeroginosa: the Problem of Rational Antibacterial Therapy. Нозокомиальные пневмонии у гематологических больных: внимание на Р. Аеroginosa.

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Repository for DZ &quot;DMA&quot;

Repository for DZ "DMA"