tailieunhanh - Báo cáo y học: "Vacuum-assisted closure device in intensive care unit patients and dissemination of Gram-negative bacteria"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Vacuum-assisted closure device in intensive care unit patients and dissemination of Gram-negative bacteria. | Papanikolaou et al. Critical Care 2010 14 413 http content 14 2 413 CRITICAL CARE LETTER Vacuum-assisted closure device in intensive care unit patients and dissemination of Gram-negative bacteria Metaxia N Papanikolaou1 Margarita Balla1 Panagiotis G Drimousis 1 Anna Xanthaki2 Athanasia Tsirigga2 and Aikaterini A Charalambous1 See related research by Batacchi etal http content 13 6 R194 We read with interest the study by Batacchi and colleagues in a recent issue of Critical Care 1 . Vacuum-assisted closure VAC decompression is promising for the management of open abdomen but our limited experience with this system suggests that dissemination of bacteria may occur. Recently two patients were treated with VAC in our intensive care unit ICU . Patient 1 was a 62-year-old man who was originally operated on for paraganglioma and underwent left nephrectomy and gastrojejunal anastomosis. Patient 2 was a 54-year-old woman who was admitted to the ICU two months after a complicated laparoscopic sleeve gastrectomy for morbid obesity. In both patients at a certain point during their course intra-abdominal sepsis developed and they were both managed with extensive debridement drainage and VAC placement. Both patients developed fistulas and although dressings and VAC pump containers were meticulously changed leaks were repeatedly observed around the dressings. Furthermore 2 to 4 weeks after the placement of VAC a rise of positive cultures for Gram-negative bacteria was observed in all patients in our ICU Figure 1 . As depicted in Figure 2 Klebsiella pneumoniae species became prevalent in our flora despite barrier measures and the isolation of both patients in a separate ward. In 12 out of 34 cases KPC K. pneumoniae was isolated whereas in one case it was resistant to all antibiotics. Recent literature is inconclusive on this subject. We believe that further studies are needed to confirm the dissemination of bacteria from patients with VAC devices and .