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  • COMPARISON OF TRACHEAL ASPI...
    Jakic, Ivana; Tamas, Ines; Bogdan, Maja; Sminderovac, Alan; Madunovic, Ivana Gugic; Gugic, Mislav; Kvolik, Slavica

    Acta clinica Croatica (Tisak), 03/2023, Letnik: 62, Številka: S1
    Journal Article

    Changes in working methods and diagnostics using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) diagnostics that occurred after the start of the COVID-19 pandemic could show differences in the prevalence of positive microbiological samples. In a retrospective study, a total of 442 tracheal aspirates in the pre-pandemic period (Period A, 2018, 198 patients, age median 69 (57-78)) and 277 samples in the pandemic period (Period B, 2021, 147 patients, age 68 (56-77) (p=0.585) obtained after the start of the pandemic were analyzed. A total of 176 patients had at least 1 positive result. In Period A, there were 245 (55%) and in Period B 186 (68%) sterile samples (p=0.001). The most frequently isolated pathogens were Acinetobacter baumannii in 86 patients from Period A and 32 patients from Period B, i.e., 43% vs. 21.7% of all positive isolates (p=0.247), followed by Pseudomonas aeruginosa in 29 patients in Period A (14.6%) vs. 7 (3%) (p=0.112) in Period B. A statistically significant increase was observed in the incidence of Enterobacterales (16.6% vs. 32.6%, p=0.002), especially Klebsiellae spp. Although overall mortality decreased in Period B, changes in the working methods and diagnostics did not result in changes in the mortality of patients whose tracheal aspirates were sampled. Key words: Spectrometry, mass; Matrix-assisted laser desorption-ionization; Pneumonia; Intensive care units; Microbiology Promjene u metodama rada i dijagnostici primjenom dijagnostike laserske desorpcije/ionizacije masene spektrometrije uz pomoc matrice (MALDI-TOF), koje su se dogodile nakon pocetka pandemije COVID-19 mogle bi pokazati razlike u ucestalosti pozitivnih mikrobioloskih uzoraka. U retrospektivnoj studiji analizirano je ukupno 442 aspirata traheje u razdoblju prije pandemije (Razdoblje A) (2018., 198 bolesnika, medijan dobi 69 (57-78) godina) i 277 uzoraka (2021., 147 bolesnika, 68 (56-77) godina, p=0,585) uzorkovanih nakon pocetka pandemije (Razdoblje B). Ukupno 176 bolesnika imalo je barem jedan pozitivan nalaz. U Razdoblju A bilo je 245 (55%) sterilnih uzoraka, dok ih je u Razdoblju B bilo 186 (68%) (p=0,001). Najcesce izolirani uzrocnici bili su Acinetobacter baumannii u 86 bolesnika iz Razdoblja A i 32 iz Razdoblja B, tj. 43% naspram 21.7% svih pozitivnih izolata (p=0,247), potom Pseudomonas aeruginosa u 29 bolesnika u Razdoblju A (14,6%) naspram 7 (3%) (p=0,112) u Razdoblju B. Statisticki znacajan porast primijecen je u incidenciji Enterobacterales (16,6% prema 32,6%, p=0,002), osobito vrste Klebsiellae. Iako se ukupna smrtnost smanjila u poslijepandemijskom razdoblju (Razdoblje B), promjene u radnim metodama i dijagnostici nisu rezultirale promjenama u smrtnosti bolesnika kojima su uzorkovani aspirati dusnika. Kljucne rijeci: MALDI-TOF masena spektometrija; Pneumonija; Jedinica intenzivnog lijecenja; Mikrobiologija