Distribution and drug resistance of intestinal pathogenic bacteria after trauma in emergency patients with severe brain injury
OBJECTIVE To investigate the distribution and drug resistance of intestinal pathogens in patients with severe brain injury 48 hours after trauma,and to provide clinical data for clinical application of antibacterial drugs.METHODS The patients with moderate to severe traumatic brain injury admitted to the emergency department of Lin'an People's Hospital affiliated to Hangzhou Medical College from Jan 2020 to Dec 2022 were enrolled.Stool samples from the patients(n=100)who met the inclusion criteria for admission to the intensive care unit were collected at the 0,24 th and 48 th hours.The total number of anaerobic bacteria which was cultured in VL-G roll tube agar added 0.2％cellobiose and 0.2％maltose was detected by Hungate roll-tube technique.And the bacteria cultured in the plate were identified by BACTECFXTOP automatic bacteria/drug sensitivity tester.drug sensitivity test was carried out by using compatible antimicrobial drug sensitivity test paper.RESULTS A total of 100 patients were included in the study.The rectal microbial samples were collected from the patients at 0,24 and 48 h.All the bacteria isolated at three time points belonged to Proteaceae,of which Enterobacteriaceae constituted the largest group,and Escherichia coli,Pseudomonas aeruginosa,Klebsiella pneumoniae and Proteus mirabilis were the most common strains,respectively.Within 0-48 h,the composition ratio of the opportunistic pathogen P.mirabilis changed significantly,which increased rapidly and had higher drug-resistant rate to cefazolin,levo-floxacin and penicillin.CONCLUSION Forty-eight hours after traumatic brain injury,patients with severe brain in-jury are associated with extensive colonization of P.mirabilis.The colonization of cefazolin,levofloxacin,and pen-icillin-resistant P.mirabilis indicates the importance of correct and rational use of antibiotics.
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