Microbial etiology of early-onset pneumonia in acute period of severe traumatic brain injury

Despite modern advances in intensive care and epidemiology, patients with severe traumatic brain injury (TBI) have high risk of infectious complications. According to some studies, the most common infection in these patients is pneumonia. Objective. To assess changes in etiology and resistance of pathogens of early pneumonia in acute period of severe TBI. Material and methods. A prospective observational study was carried out between 2010 and 2021. The study included 94 patients aged 18—75 years in acute period of severe TBI (GCS score <8). There were 69 men. All patients were transferred from primary hospital within 72 hours after TBI. Microbiological tests of blood, urine and endotracheal aspirate were performed in all patients upon admission with further assessment of antibiotic resistance of pathogens. Results. Over the past years, gram-negative carbapenem-resistant flora including Acinetobacter baumannii and Klebsiella pneumoniae prevailed as pathogens of early pneumonia in acute period of TBI. The most common causative agent of early pneumonia among gram-positive flora is Staphylococcus aureus. More than 25% of these cases are characterized by resistance to oxacillin. Conclusion. In recent years, the number of resistant strains of A. baumanii, Kl. pneumoniae and S. aureus causing early pneumonia in acute period of TBI is steadily increasing. Analysis of epidemiological profile of in-hospital infectious complications is extremely important for rational approaches to early empirical antibacterial therapy. Early diagnosis of antibacterial resistance is a fundamental factor for effective antibacterial therapy.