Risk factors and peripheral blood lymphocyte subset analysis of patients with ventilator-associated pneumonia: a Chinese population-based study

摘要

The aim of this study is to analyze and identify ventilator-associated pneumonia (VAP) risk factors related to pathogens and drug resistance, and explore the theoretical guidance for clinical prevention and treatment strategies of VAP. 478 cases using a ventilator who were hospitalized in July 2014 to November 2016 in our hospital were analyzed in this study. Among them there were 103 patients with VAP. The distribution of pathogenic bacteria and drug resistance in VAP patients was detected and analyzed. 103 patients had VAP (21.5%, 103/478) among 478 cases of patients using a ventilator. Among the 103 patients with VAP, 35 patients died and 43 had simultaneous sepsis. Compared with those of the non-VAP group, the proportion of CD3 (p = 0.012), CD3 CD4 (P = 0.024) and CD8 CD28 (P = 0.017) T cells in VAP group increased significantly, which showed a more severe immune response. Multivariate regression model analysis revealed that tracheotomy for mechanical ventilation (P = 0.013), mechanical ventilation time ≥ 7 days (P = 0.02) and aspiration and reflux (P = 0.011) were independent risk factors associated with VAP. Multi-drugs resistance was observed in this study. Modality of mechanical ventilation, mechanical ventilation ≥ 7 days, and aspiration and reflux were independent risk factors associated with VAP. According to the results of bacterial culture and drug sensitivity test, rational selection of antibiotics and monitoring of patients in the ICU can effectively control the incidence of VAP and improve prognosis.