Analysis Of Risk Factors And Etiology Of Ventilator Associated Pneumonia In Medical Intensive Care Unit

Objective: To analyze the characteristics of riskfactors and etiology in patients with ventilator associatedpneumonia (VAP) in medical intensive care unit(MICU). Methods:Retrospective analysis was performed on the clinic data,bacterial culture, antibiotics sensitivity results in 41 patientswho had received mechanical ventilation in MICU from June 2005to August 2006. Results: The diagnosis of VAP was established in16 cases with the incidence of 39％. The rate of VAP was 45.3 casesper 1000 ventilator days. The score of APARCHEII(p=0.005), gastricacid secretion inhibitor therapy (OR 6.97, 95％CI 1.72～28.3) andthe duration of mechanical ventilation (p=0.006) were the riskfactors for VAP. The mortality of patients with VAP was more thanothers without VAP (OR34.5, 95％CI5.51～216.2) in MICU. Early onsetof VAP was caused predominantly by Gram positive bacteria, butLate onset of VAP was by Gram negative bacteria. Drug resistantmicroorganisms were common. Conclusion: The more active controlof the risk factors of VAP may reduce the burden of VAP. Thedistinguish of the types of VAP and the acknowledge of theprevailing bacterial pathogens in MICU is helpful before using antibiotics.