Immunity Function And Prognosis In Patients With Hospital-acquired Pneumonia Due To Multidrug-resistant Acinectobacter Baumannii In Intensive Care Unit

Objective: To analyse the immunity function and prognosis of hospital-acquired pneumonia due to multidrug-resistant Acinectobacter baumannii(MDRAB)for better prevention and control of such infections so as to decrease the mortality of patients.Method: A total of 87 cases of hospital-acquired pneumonia caused by MDRAB were treasured in the fisrt affiliated hospital of GuangXi Medical University during the period from June 2011 to June 2016.The clinical data of these patients were reviewed retrospectively.Additional 62 cases of hospital-acquired pneumonia caused by non-multidrug-resistant Acinectobacter baumannii were included as control group.When hospital infection was diagnosed,ages,sexes,Apache II scores,T lymphocyte,CD4+ T cell,CD8+ T cell,NK cell,immunoglobulin G,immunoglobulin M,immunoglobulin A,procalcitonin,leukocyte,C-reactive protein were compared.The prognostic factors for the 87 cases of hospital-acquired pneumonia due to MDRAB were analyzed by univariate and multivariate Logistic analysis between the 24 deaths and 63 survivals.In order to predict the hospital infection,these immune and inflammatory indicators need to be observed.The t-test,chi-square test were used for statistics analysis.Results: There were no significant difference in ages,sexes,CD8+ T cell,NK cell,procalcitonin,leukocyte,C-reactive protein,immunoglobulin G,immunoglobulin M(P>0.05).There were difference in CD4+ T cell,immunoglobulin A,Apache II scores(P<0.05).Drawing receiver operating characteristic(ROC)for CD4+ T cell,immunoglobulin A,as for CD4+ T cell,the area under the curve(AUC)was 0.608,the sensitivity is 62.7%,specificity is57.5%;As for immunoglobulin A,the area under the curve(AUC)was 0.637,the sensitivity is 58.7%,specificity is 76.4%,and they were equipped with larger diagnosis value.Conclusions: The CD4+ T cell,immunoglobulin A and Apache II scores were equipped with diagnosis value to differentiate the hospital infection from MDRAB HAP and NMDRAB HAP.As for MDRAB HAP,its immune function is of great significance to its prognostic assessment.