Quantitative biofilm for bacterial pathogens of ventilator-associated pneumonia

Background & Objective: Ventilator–associated pneumonia (VAP) is one of the most common nosocomial infections in clinical care settings. Several bacteria with biofilm–producing ability offer serious challenge in their eradication. Prompt and accurate diagnosis is needed to provide the best care for the patients. This study aimed to analyze whether biofilm examination using quantitative method can be used as a diagnostic tool for bacterial pathogens associated with VAP. Methodology: This observational analytical study was conducted in Intensive Care Units of three teaching hospitals in Surakarta, Central Java, Indonesia, from November 2019 to April 2020. The subjects were between 19 and 65 y old, with a newly introduced endotracheal tube (ETT) connected to mechanical ventilators, and without pneumonia. Biofilm quantitative measurement used a microtiter plate method from bacterial culture found on ETT at the 48th hour after being mechanically ventilated. The Clinical Pulmonary Infection Score (CPIS) assessment was done at the 48th hour and CPIS of less than 6 was defined as VAP. The analysis used Spearman’s rank and Kendall tau–b correlation. The samples were taken using a consecutive sampling technique. Results: A significant correlation between biofilm and VAP was found (ρ = 0.039, p < 0.05). Biofilm was also sufficiently correlated with an increase in CPIS (τb = 0.341, p < 0.05) Conclusions: Quantitative biofilm can be used as a diagnostic tool for establishing the diagnosis of VAP so that appropriate therapy can be administered immediately. Key words: Bacterial pathogen; Biofilm; Ventilator–associated pneumonia Abbreviations: CPIS: Clinical Pulmonary Infection Score; VAP: Ventilator–associated pneumonia; ETT: Endotracheal tube; PCR: Polymerase chain reaction; OD: Optical density Citation: Dewi FH, Suradi, Purwanto B, Wasita B. Quantitative biofilm for bacterial pathogens of ventilator-associated pneumonia. Anaesth. pain intensive care 2021;25(2):132-137. DOI: 10.35975/apic.v25i2.1468 Received: 24 September 2020, Reviewed: 27, 30 October 2020, Accepted: 3 March 2021

HUBUNGAN SKOR MODIFIED SEQUENTIAL ORGAN FAILURE ASSESSMENT (MSOFA) DENGAN KEJADIAN VENTILATOR ASSOCIATED PNEUMONIA (VAP) PADA PASIEN YANG TERPASANG VENTILATOR

Kegagalan multi organ pada pasien dirawat di ICU dapat meningkatkan terjadinya Ventilator Associated Pneumonia (VAP). Tujuan penelitian ini untuk melihat hubungan skor Modified Sequential Organ Failure Assessment (MSOFA) dengan kejadian VAP pada pasien yang terpasang ventilator. Desain penelitian ini adalah retrospective study. Jumlah sampel pada penelitian ini adalah 36 orang responden yang diambil dengan teknik purposive sampling yang memenuhi kriteria inklusi. Data pada penelitian ini diperoleh dari rekam medis pasien yang dirawat di ICU dari Januari sampai Agustus 2019 diruang rekam medis. Alat ukur yang digunakan lembar observasi untuk melihat karakteristik pasien, skor MSOFA pada hari pertama dan Clinical Pulmonary Infection Score (CPIS) pada hari ketiga. Hasil penelitian ini didapatkan mayoritas diagnosis medis responden bedah saraf (44,4%), rerata untuk umur responden 52 tahun, rerata lama hari rawat 7 hari dan rerata lama pemakaian ventilator 85 jam 15 menit. Hasil analisis bivariat didapatkan nilai r 0,453, p value 0,006 lebih kecil dari nilai alpha 0,05 (p value < α). Kesimpulan terdapat hubungan antara skor MSOFA dengan kejadian VAP dan berpola positif dimana semakin tinggi skor MSOFA maka akan semakin tinggi risiko terjadi VAP, pada pasien yang terpasang ventilator di ICU RSUD Arifin Achmad Provinsi Riau. Skor MSOFA dapat memprediksi kejadian VAP sehingga dapat memotivasi perawat untuk menggunakan skor MSOFA dalam mengobservasi kejadian VAP.