The Predisposing Factors And Drug Resistance Diversify For Ventilator-Associated Pneumonia In Respiratory Intensive Care Unit

Objective To investigate the predisposing factors and the diversify of drug resistance for Ventilator-associated pneumonia (VAP) in the respiratory intensive care unit(RICU)in the first affiliated hospital of ChongQing Medical University.Methods The retrospective analysis were performed on the 341 cases of patients who were treated with mechanical ventilation (MV) ,they were grouped into two parts by with or without VAP.Then the VAP group were divided into two groups (group A,group B) according to the time of their onste, between which the comparison of the sputum culture and antibiotics-sensitivity results were carried out.Results The attack rate of VAP in RICU of our hospital was 49.3%. The predisposing factors for VAP were age, the basis of disease, nutritional state, coma, the time for MV, the use of tranquilizers, the use of antibiotics and glucocorticoids before MV,etc. In the group A , 143 strains of bacterium were found from the total 58 patients,from which 104 strains (about 72.7%) were gram negative bacilli(GNB),22 strains (about 15.4%) were gram positive coccus (GPC),and 17 strains (about 11.9%) were fungus. In the group B,134 strains of bacterium were found from the total 110 patients,from which 93 strains (about 69.5%) were gram-negative bacilli(GNB),19 strains (about 14.1%) were gram positive coccus (GPC),and 22 strains (about 16.4%) were fungus. The antibiotics-sensitivity results shows that the rates of the drug fast is very high,and the multidrug resistant is common,but each pathogenic bacterium still having the corresponding sensitive antibiotics.Conclusion The incidence of VAP were associated with a variety of factors, bundle therapy should be used to prevent the morbidity of VAP. The main VAP pathogenic bacterium in RICU was gram negative bacilli. As the time goes,the rates of the drug fast of some GNB strains of bacterium is increasing. The fungus infection is increased in recently years,the multi-drug resistant pathogenic bacterium are also increasing. So its very important to choose the antibiotics according to the results of the antibiotics-sensitivity for the VAP treatment.