Study On Pathogens And The Risk Factors Of Ventilator-associated Pneumonia Of Stroke

Objective: To analyze the characteristic of pathogens and risk factors in patients with ventilator-associated pneumonia(VAP)of sthoke.Method: A total of 68 patients received ventilator treatment from December 2012 to December 2016 in our hospital were retrospectively reviewed and 48 patients were diagnoses as VAP.Chi-square test and Logistic regression model were performed.Results: Univariate analysis indicated that these variables including gender,age,and nationality not reached statistical significance between VAP and not VAP group(P>0.05).However,there were statistically significant differences(P<0.05)in terms of gasrointestinal reflux and aspiration,the score APACHE-II,GCS,the lasting time of mechanical ventilation,using antacids.Multivariate analysis suggested that incidence of gastrointestinal reflux and aspiration(OR:7.032;95%CI: 1.257-39.343;P=0.026),thescore APACHE-II(OR: 5.385;95%CI:1.034-28.049;P=0.046),usingantacidswere(OR:6.512;95%CI:1.147-37.013;P=0.013),the score of GCS(OR:8.564;95%CI:1.668-43.956;P=0.010),and the lasting time of mechanical ventilation(OR: 0.145;95%CI: 0.031-0.666;P=0.013)were associate with VAP generation.The most pathogenic bacteria of VAP was gram-negative bacillus,following gram-positive bacterium and fungus.In gram-negative bacillus,the most was acinetobacter baumannii and staphylococcus aureus for gram-positive bacterium,and candida albicans for fungus.Conlusion: Incidence of gastrointestinal reflux,ventilation time,using antacids the score of APACHE-II,GCS were risk factors for VAP generation in patients of sthoke.The most pathogenic bacteria of VAP was gram-negative bacillus and analysis of antibiotic resistance could provide evidence for the rational usage of antibiotics for treating VAP.