Risk Factors And Pathogenic Bacteria Analysis Of Early And Late Onset Ventilator-associated Pneumonia

Objective: By analyzing and comparing the risk factors,pathogenic bacteria distribution and antimicrobial resistance of early onset ventilatorassociated pneumonia(E-VAP)and late onset ventilator-associated pneumonia(L-VAP),clinical help is provided for the prevention and treatment of VAP.Methods: Clinical data of 380 patients admitted to the Department of Emergency,Respiratory and Intensive Care with mechanical ventilation duration ≥48h in Shengjing Hospital Affiliated to China Medical University from June 2020 to September 2022 were analyzed.According to occur when the mechanical ventilation of VAP time divided into E-VAP(mechanical ventilation time 5 days)and L-VAP(mechanical ventilation time 5 days or more),including the VAP group(204 cases),and E-group(44 cases)VAP,L-VAP group(132 cases),analyze the related risk factors and pathogenic bacteria of VAP.Results: The common risk factors of E-VAP and L-VAP were hormone use,APACHE-II score ≥18 points,albumin value,CCI score and hemoglobin value.Independent risk factors for L-VAP include CRP,oxygenation index,and blood glucose.The prediction value of albumin to E-VAP and L-VAP was better than other indexes.The pathogens isolated from E-VAP and L-VAP patients were mainly Gram-negative bacilli,of which Acinetobacter baumannii accounted for the largest proportion,followed by Klebsiella pneumoniae and Pseudomonas aeruginosa,and all gram-positive bacteria were Staphylococcus aureus.There was no statistical significance in the distribution of pathogenic bacteria between the two.The bacteria producing ESBLs were mainly composed of Klebsiella pneumoniae and Escherichia coli.The enzyme producing strains all showed different degrees of multiple drug resistance.The Es BLs-producing strains were highly sensitive to tegacycline,β-lactamase inhibitor compound preparations and carbapenems.The resistance rate of L-VAP Gram-negative bacteria to common antibiotics was significantly higher than that of E-VAP,which was statistically significant.Conclusion: The pathogens isolated from E-VAP and L-VAP were mainly Gram-negative bacilli.There was no significant difference in the distribution of pathogens between the two groups,and L-VAP resistance was more serious.The risk factors of E-VAP and L-VAP are different,so different preventive measures should be taken.