Antibiotics

Description of Clinical Characteristics of VAP Patients in MIMIC Database

Background: Ventilator-associated pneumonia (VAP) is a common and serious nosocomial infection of intensive-care units (ICUs). Accurate, timely diagnosis enables early VAP patients to receive appropriate therapies and reduce the occurrence of complication. However, so far clinical datas regarding the epidemiology and mortality of VAP are still limited. Medical Information Mart for Intensive Care (MIMIC) database is a free, open and public resource about ICU research database. MIMIC database is a free, open, public database that collects information on more than 40,000 ICU patients who are predominantly white people. Therefore, the purpose of the present study is to observe and describe the clinical characteristics of VAP patients in ICU from the MIMIC database.

Method: A total of 418 patients were enrolled in the study. General information, ventilator use information, microbiology information, antibiotic use information, and some nursing-related information were extracted to describe and analyze the clinical features of VAP patients.

Results: The results of the study showed that patients with one or three pathogens were the most. The main pathogens were YEAST (16.71%), STAPH AUREUS COAG+ (11.63%), Staphylococcus, COAGULASE NEGATIVE (8.68%), GRAM NEGATIVE ROD (S) (6.14%), and Pseudomonas aeruginosa (5.73%). Patients using 4 antibiotics were the most. The top five antibiotics in the largest proportion were synthetic antibacterials (24.66%), peptides (20.13%), cephalosporins (19.60%), penicillins (13.54%), and aminoglycosides (5.27%).

Conclusion: This study summarizes the common pathogens of VAP and the antibiotics commonly used in the treatment of VAP by describing the clinical information of 418 patients with VAP in the MIMIC database. In clinical treatment, we should pay attention to aseptic operation, develop appropriate antibacterial measures, closely monitor the pathogens of VAP infection, and use antibiotics in a timely manner to control the occurrence and development of VAP.

Studies on diarrheagenic Escherichia coli isolated from children with diarrhea in Myanmar

Escherichia coli isolates from 217 children in Myanmar with diarrhea were investigated for the presence of virulence genes related to diarrhea by colony hybridization and PCR. The genes examined were lt, stI, stII, stx1, stx2, eae, bfp, pCVD (which is the representative gene of plasmid of pCVD of EAEC), and ial (which is invasion-associated locus of the invasion plasmid found in EIEC). Isolates from 47 of 217 children (21.7%) possessed virulence genes characteristic of diarrheagenic E. coli. No instance was found of co-existence of different E. coli strains with different virulence genes in the same patient. Diarrheagenic E. coli are currently classified into five categories based on their virulence markers: ETEC, EHEC, EPEC, EAEC, and EIEC. Of the 47 isolates examined, 30 were EAEC, 12 were EPEC and 5 were ETEC. Susceptibility tests for antimicrobial agents showed that almost all diarrheagenic isolates were resistant to penicillin, tetracycline and streptomycin. However, the majority of strains were sensitive to cephalexin, nalidixic acid and norfloxacin. In particular, 42 of the 47 isolates were sensitive to norfloxacin, which is a fluoroquinolone. This study shows EAEC and EPEC are responsible for sporadic diarrhea in Myanmar and fluoroquinolones appear to be effective in the treatment of these patients.