Pathogenic Bacteria Of Ventilator-associated Pneumonia And Analysis Of Syndrome In TCM

BackgroundVentilator-associated pneumonia (VAP)is one of the severe complications of mechanical ventilation, is the leading cause of death in patients with Hospital acquired infection. Lead to prolonged hospital stay and increased cost. With mechanical ventilation in acute critical patients increased, more and more clinical attention is paid on ventilator-associated pneumonia. Now, mainly through the research the risk factors to guide the prevention of the occurrence of VAP, Through the study of pathogenic bacteria and drug resistance, antibiotic use, guide VAP treatment to reduce their morbidity and mortality rate. However, how to reduce the incidence rate of VAP, fatality is the clinical problems,some scholars seek traditional Chinese medicine intervention for treatment of ventilator-associated pneumonia, obtain certain clinical effect, but at present the VAP TCM research lack, therefore, to study the regularity of TCM syndrome, attempts to study the pathogenic bacteria and the correlation between syndrome differentiation of TCM, TCM Intervention Therapy on VAP certain clinica significance.ObjectiveRetrospect of ventilator-associated pneumonia in patients with patient characteristics, review of ventilator-associated pneumonia pathogenic bacteria distribution, for early anti-infective therapy on VAP to provide reference. Understanding the distribution regularity of TCM syndrome factors of pathogenic bacteria, and TCM syndrome factors correlation, for the development of ventilator-associated pneumonia in the TCM treatment plan provide a basis.Methods Retrospective investigation way, were collected in78cases of investigation object, are from Guangdong Province Traditional Chinese Medical Hospital Fangcun branch ICU hospitalized VAP patients, patients with documented ventilator-associated pneumonia pathogens and elements of TCM syndromes. Statistics of ICU ventilator-associated pneumonia pathogenic bacteria distribution, analysis of the characteristics of TCM syndrome of pathogen, and the correlation between syndrome differentiation of TCM.Results1. Pathogenic bacteria of ventilator associated pneumonia in Gram-negative bacilli mainly. Pathogenic bacteria in5ranked as:Bauman Acinetobacter (23.8%), Pseudomonas aeruginosa (21%), Cray Borrelia bacteria pneumonia (15.4%), Staphylococcus aureus (14%), Escherichia coli (7%). Multi drug resistant bacteria amounted to56.3%, among them Bauman Acinetobacter strains as high as94.1%2. Patients with ventilator associated pneumonia in three kinds of TCM syndrome type (empirical, deficiency, the actual situation mixture card), the actual situation mixture accounted for the highest proportion (83.3%), simple empirical (14.1%) and herpes deficiency is uncommon (2.6%). One of the virtual qualitative to Qi deficiency is the most common (65.4%), followed by Yang deficiency (32.1%), standard qualitative to phlegm was the most common (88.5%), followed by the blood stasis syndrome (47.4%), hot (34.6%), wetcard (17.9%), FU-Organ syndrome(16.7%). Early onset VAP patients than later onset VAP patients was significantly increased in FU-Organ syndrome, the difference was statistically significant (P<0.05).3.Presence of qi deficiency syndrome in patients with VAP detection of Gram-negative bacteria ratio increased significantly, the actual situation mixture to a positive VAP patients, the detection of Gram-negative bacteria ratio also increased significantly, the difference was statistically significant (P<0.05).ConclusionPathogens of Ventilator-associated pneumonia is gram-negative bacilli mainly. Most of the pathogens is Drug resistance bacteria. The syndrome of traditional Chinese medicine, syndrome of intermingled deficiency and excess largest proportion, the virtual qualitative to Qi deficiency is the most common, standard qualitative to phlegm is the most common, therefore, traditional Chinese medicine, in the band at the same time, also need to take into consideration both upright. Early onset of late onset VAP patients with excess syndrome of increased significantly, pay attention to by treatment based on syndrome differentiation.