Comparison of pathogenic bacteris characteristics between praecox and tardus ventilator-associated pneumonia in the elderly / 中华老年医学杂志

ABSTRACT

Objective To compare of pathogenic bacteria characteristics between praecox and tardus ventilator-associated pneumonia (VAP) in the elderly with critical illness,and to provide the guildline and evidence of clinical prevention and treatment. Methods The clinical data of 276 VAP patients aged (69.3 ± 5.3) years in our hospital were retrospectively analyzed.There were 97cases (35.14％) with praecox VAP,179 cases (64.86％) with tardus VAP.Vitek 32 system was applied to identify pathogenic bacteria. Results In patients with praecox VAP,105 pathogenic bacteria were isolated,among which 72 cases(68.57％) suffered from G- bacterium,21 cases (20.00％) from G+ and 12 (11.43％) from fungus. The most widely distributed pathogens were hemophilus (22.86％),streptococcus pneumoniae(14.28％ ) and staphylococcus aureus(14.28％).In the patients with tardive VAP,186 pathogenic bacteria were isolated including 117(62.90％) G- bacterium,54 (29.04％)G+ bacterium and 15 (8.06％) fungus; the most widely distributed pathogens were staphylococcus aureus (24.19％), pseudomonas aeruginosa (22.58％) and klebsiella pneumoniae (14.52％).The death rate of tardus VAP(24.58％) was significantly higher than of praecox VAP (10.31％ ) (x2 =8.14,P＜0.05).The durations in ICU and mechanical ventilation were much longer in tardus VAP[(10.3±4.2)d and (7.8±2.7)d] than in praecox VAP[(7.8±3.1) d and (3.7±1.1)d] (t=5.15,14.32,P＜0.05). Conclusions There is differences in pathogenic bacteria distribution between praecox and tardus VAP,and the prognosis of tardus VAP may be worse.