Analysis Of The Risk Factors And Pathogenic Bacteria Distribution Of Ventilator-associated Pneumonia

Objective To analyze pathogenic bacteria distribution and related clinical characteristics of ventilator-associated Pneumonia(VAP)in patients who were treated with invasive mechanical ventilation in our hospital,and to provide the basis of the early prevention and control of ventilator associated pneumonia.Methods A retrospective analysis was conducted to the patients who were treated with mechanical ventilation in our hospital from September 1,2015 to August 31,2016.In order to study the pathogenic bacteria distribution and drug resistance rate,and analyze risk factors of VAP in patients,we conducted Excel 2003 and SPSS 17.0 to analyze patients' gender,age,underlying disease,invasive manipulation,mechanical ventilation time,hospitalization time,etc.Results 751 patients were treated with mechanical ventilation and 664 of them were treated with invasive mechanical ventilation,incidence of Ventilator-associated Pneumonia(VAP)was 37.86%.296 strains of pathogenic bacteria were isolated.Most of bacteria samples were obtained from sputum(82.09%),blood(7.09%),urine(2.70%),tracheal intubation(2.36%),cerebrospinal fluid(2.36%)and other samples(3.38%).Gram-negative bacteria,gram-positive bacteria and fungi accounted for 84.80%?6.42%and 8.78%,respectively.According to the result of drug susceptibility tests,Acinetobacter baumannii(74 strains,25.00%),Pseudomonas aeruginosa(65 strains,21.96%),Klebsiella pneumonia(21 strains,7.09%)and Escherichia coli(17 strains,5.74%)were four main types of gram-negative bacteria,and the main type of gram-positive bacteria was Staphylococcus aureus(16 strains,5.41%).Fungi included11 strains Candida Albicans(3.72%),9 strains Candida glabrata(3.04%),4strains Candida tropicalis(1.32%),2 strains other fungi(0.68%).According to single factor Logistic regression analysis,the risk factors of VAP included consciousness of patients,indwelling gastric tube,keeping catheter,antibiotics,over 7 days antibiotic application,more than three types of antibiotics application,extension of duration of mechanical ventilation,ICU length of stay and total length of stay.Furthermore,according to Multivariate Logistic regression analysis,consciousness of patients,over 7 days antibiotic application and extension of duration of mechanical ventilation are independent risk factors of ventilator-associated pneumonia.Conclusions Gram-negative bacteria accounted for the largest proportion of pathogenic bacteria in patients treated with ventilator.For the purpose of instructing antibiotics selection in clinical practice,it is necessary to explore the rate of drug resistance and other risk factors.