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. 2019 Oct 1;12(10):3830-3838.
eCollection 2019.

Risk factors and peripheral blood lymphocyte subset analysis of patients with ventilator-associated pneumonia: a Chinese population-based study

Jiefang Zhang  1 , Rong Deng  1 , Huijuan Jia  1 , Xiuxian Li  1
Affiliations

Risk factors and peripheral blood lymphocyte subset analysis of patients with ventilator-associated pneumonia: a Chinese population-based study

Jiefang Zhang et al. Int J Clin Exp Pathol. .

Abstract

The aim of this study is to analyze and identify ventilator-associated pneumonia (VAP) risk factors related to pathogens and drug resistance, and explore the theoretical guidance for clinical prevention and treatment strategies of VAP. 478 cases using a ventilator who were hospitalized in July 2014 to November 2016 in our hospital were analyzed in this study. Among them there were 103 patients with VAP. The distribution of pathogenic bacteria and drug resistance in VAP patients was detected and analyzed. 103 patients had VAP (21.5%, 103/478) among 478 cases of patients using a ventilator. Among the 103 patients with VAP, 35 patients died and 43 had simultaneous sepsis. Compared with those of the non-VAP group, the proportion of CD3+ (p = 0.012), CD3+ CD4+ (P = 0.024) and CD8+ CD28+ (P = 0.017) T cells in VAP group increased significantly, which showed a more severe immune response. Multivariate regression model analysis revealed that tracheotomy for mechanical ventilation (P = 0.013), mechanical ventilation time ≥ 7 days (P = 0.02) and aspiration and reflux (P = 0.011) were independent risk factors associated with VAP. Multi-drugs resistance was observed in this study. Modality of mechanical ventilation, mechanical ventilation ≥ 7 days, and aspiration and reflux were independent risk factors associated with VAP. According to the results of bacterial culture and drug sensitivity test, rational selection of antibiotics and monitoring of patients in the ICU can effectively control the incidence of VAP and improve prognosis.

Keywords: Ventilator-associated pneumonia; pathogen analysis; risk factors.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Peripheral lymphocyte subset analysis of patients between VAP group and non-VAP group.
Figure 2
Figure 2
Multiple analysis of peripheral lymphocyte subsets for VAP.
Figure 3
Figure 3
Peripheral lymphocyte subset analysis of patients stratified by survival in patients with VAP.
Figure 4
Figure 4
Peripheral lymphocyte subset analysis of patients stratified by sepsis in patients with VAP.
See this image and copyright information in PMC

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