Ventilator-associated Pneumonia due to Acute Lung lnjury and Acute Respiratory Distress Syndrome after Severe Injury:High Risk Factors and Clinical Characteristics / 中华医院感染学杂志

ABSTRACT

OBJECTIVE To explore the incidence rate,pathogen distribution and characteristics of drug resistance of ventilator-associated pneumonia(VAP) patients due to acute lung injury and acute respiratory distress syndrome(ALI/ARDS) after severe injury,and analyze impact factors on VAP.METHODS All 183 cases with ALI/ARDS after severe injury from Jan 2004 to Mar 2008,were admiitted and given mechanic ventilation over 48 hours in our ICU and EICU.RESULTS VAP was found in 98 cases,accounted for 53.56%.Among them,42 were early-onset VAP and the other 56 were late-onset VAP.Altogether 276 pathogens were isolated,and most of them were Pseudomonas aeruginosa,Staphylococci aureus,Klebsiella pneumoniae,Acinetobacter baumannii and Escherichia coli.In 41 cases only one pathogen was isolated,the other 57 cases were with two or above pathogens.The revealed important risk factors were coma,prolonged mechanical ventilation,tracheotomy,antiacid treatment,use of antimicrobial agents and low albumin.CONCLUSIONS The incidence rate of VAP due to ALI/ARDS is high,and most of the isolated pathogens are drug resistant.Mixed infections are found commonly in these cases.