Analysis of Pathogens and Risk Factors for Ventilator-Associated Pneumonia in Intensive Care Unit Patients

YOU Xiaoling; ZHENG Yifeng

doi:10.13919/j.issn.2095-6274.ZHJY202412012

Abstract：Objective To investigate the pathogen distribution and risk factors for ventilator-associated pneumonia(VAP)in patients in the intensive care unit(ICU)of the emergency department.Methods A retro-spective analysis was conducted on the clinical data of 293 patients who received mechanical ventilation in the Intensive Care Unit(ICU)of Jianou City Hospital,Fujian Province,from March 2021 to March 2023.Based on the occurrence of ventilator-associated pneumonia(VAP),the patients were divided into the pneumonia group(82 cases)and the non-pneumonia group(211 cases).The incidence of VAP and the distribution of pathogens in the VAP group were analyzed.Clinical baseline data of the two groups were compared to identify factors with signif-icant differences.Multivariate logistic regression analysis was used to determine the independent risk factors for the occurrence of ventilator-associated pneumonia.Results In the pneumonia group,a total of 148 pathogenic strains were identified from sputum cultures,including 116 strains of Gram-negative bacteria(78.38％),26 strains of Gram-positive bacteria(17.57％),and 6 strains of fungi(4.05％).Compared to the non-pneumonia group,the pneumonia group had significantly higher proportions of patients over 60 years old,with a hospital stay longer than 14 days,using antimicrobial agents for more than 7 days,undergoing invasive procedures,having concurrent upper respiratory tract infections,and using acid-suppressive agents(P＜0.05).Additionally,the pneumonia group had longer durations of mechanical ventilation(P＜0.05)and higher APACHE Ⅱ and SOFA scores(P＜0.001).Multivariate logistic regression analysis revealed that the following factors were independent risk factors for the occurrence of ventilator-associated pneumonia:age ≥ 60 years,hospital stay＞14 days,antimicrobial usage ≥ 7 days,prolonged mechanical ventilation,high APACHE Ⅱ and SOFA scores,invasive procedures,use of acid-sup-pressive agents,and concomitant upper respiratory tract infections(P＜0.05).Conclusion Older age,longer anti-biotic use,longer mechanical ventilation time,prolonged hospital stay,higher APACHE Ⅱ and SOFA scores,use of acid-suppressive drugs,invasive procedures,and concurrent upper respiratory tract infections all increase the risk of VAP in mechanically ventilated patients.Clinicians should strengthen preventive measures to reduce the occur-rence of VAP.