Pathogenic Bacteria Distribution And Related Cytokines Change Analysis Of Ventilator-associated Pneumonia In The ICU

Objective: Test the changes of serum IL-8 and IL-10 levels in patients with mechanical ventilation,and to explore the diagnostic value of IL-8 and IL-10 levels in patients with ventilator associated pneumonia?To observe the Pathogenic Distribution and drug resistance characteristics of ventilator associated pneumonia(VAP)in the ICU ward of our hospital,and to guide the empirical antibiotic therapy in our department VAP.Methods: During May 2015 to 2015 December,collect the mechanical ventilation patients as the research object in ICU of our hospital.According to sampling point,were divided into 3 groups: before the implementation of mechanical ventilation,collecting serum samples as mechanical ventilation 0 h group(MV0h);samples collected at implementation of mechanical ventilation over 48 hours and without VAP,were mechanical ventilation 48 hour group(MV48h);after diagnosis as VAP,collecting the samples as ventilator-associated pneumonia group(VAP).IL-8 and IL-10 levels were determined by ELISA method in each group,and the results using SPSS18.0 statistical software for t test,with P < 0.05,considered to have statistical significance.Collect the lower respiratory tract secretions of the patients with VAP,and detected pathogenic bacteria and drug sensitivity.Results: The group of MV48 h serum samples of IL-8 and IL-10 levels were higher than that of group MV0 h.VAP serum samples of IL-8 and IL-10 levels was significantly higher than that in group MV48 h.The area under the ROC curve of IL-8 was 0.782.In the serum of patients with mechanical ventilation,when the IL-8 level reached 194.52pg/ml,the sensitivity of the diagnosis of VAP was 72%,and the specificity was 82%.The area under the ROC curve of IL-10 was 0.362,which was not statistically significant.Correlation analysis results of serum IL-8,IL-10 levels and CPIS results:P > 0.05,not statistically significant.This study detected 60 cases of sputum specimens,73 strains of pathogenic bacteria,pathogen identification showed that VAP infection by gram-negative bacilli are Bauman Acinetobacter,Pseudomonas aeruginosa and Klebsiella pneumoniae in the top three.Conclusions: After 48 hours of mechanical ventilation,mechanical ventilation due to mechanical damage can cause the patient's IL-8 and IL-10 levels increased.IL-8 level of serum in patients with VAP has a certain diagnostic value.The level of IL-10 in serum has no diagnosis value of VAP.The changes of IL-8 and IL-10 in serum did not reflect the severity of pulmonary infection in patients with VAP.For patients in our department of mechanical ventilation,early empiric antibiotics should be covered by Pseudomonas aeruginosa,Bauman Acinetobacter and Klebsiella pneumoniae.