Abstract:

Objective: This study aims to elucidate the distribution of pulmonary pathogens in patients suffering from ventilator-associated pneumonia (VAP) and to investigate the factors influencing the incidence of VAP. Methods: Employing a retrospective research approach, this study involved 1164 patients who underwent mechanical ventilation at the First Hospital of Shanxi Medical University and the First People’s Hospital of Yangquan City from January 2018 to December 2021. Sputum samples were collected from each patient for pathogen detection. We gathered comprehensive demographic and clinical data, including age, gender, length of hospital stay, and surgical history. Additionally, detailed records of mechanical ventilation and the duration and frequency of indwelling urinary and central venous catheters, as well as antibiotic usage, were maintained. The study aimed to characterize the distribution of pulmonary pathogens in VAP patients and utilized a multivariate logistic regression model to identify and analyze the factors influencing the incidence of VAP among the subjects. Results: Among the 1164 participants enrolled in this study, 171 cases (14.69%) developed VAP. Analysis revealed a total of 378 pathogenic strains isolated from the lower respiratory tract or tracheal intubation terminal secretions of these patients. Of these, 298 strains were Gram-negative bacteria (78.84%), 66 were Gram-positive bacteria (17.46%), and 14 were fungal strains (3.70%). Predominant pathogens included Klebsiella pneumoniae and Acinetobacter baumannii, constituting 23.81% (90/378) and 14.81% (56/378) of the isolates, respectively. Multivariate logistic regression analysis identified surgical interventions (OR=2.506, 95%CI=1.640-3.828), prolonged hospital stays of 14 days or more (OR=2.749, 95%CI=8.424-28.968), and the use of indwelling catheters (OR=14.208, 95%CI=5.285-38.192) as independent risk factors significantly associated with the occurrence of VAP in mechanically ventilated patients. Conclusion: Conditional pathogens predominantly contribute to respiratory infections in patients receiving mechanical ventilation. Patients who have undergone surgical procedures, those with prolonged hospital stays, or those with indwelling catheters should be particularly vigilant regarding the elevated risk of developing ventilator-associated pneumonia (VAP).

Key words: Ventilators, mechanical, Infection, Pneumonia, ventilator-associated, Factor analysis, statistical