Pathogenic bacteria distribution and clinical characteristics of ventilator associated pneumonia in patients with chronic obstructive pulmonary disease

Abstract

Objective To explore the pathogenic bacteria distribution and clinical characteristics of ventilator associated pneumonia(VAP) in patients with chronic obstructive pulmonary disease(COPD). Methods 54 COPD patients with respiratory failure were selected as the research subjects, they were taken endotracheal intubation or cut operation mechanical ventilation for treatment, for the specimens collected in the lower respiratory tract secretions or bronchoalveolar lavage fluid, bacteria isolation, culture and drug sensitivity test, and the pathogen distribution, drug resistance and clinical characteristics were analyzed. Results 82 strains of pathogens were selected in 54 specimens, including gram negative bacteria 54 strains(65.85%), common with Pseudomonas aeruginosa(24.39%), Acinetobacter baumannii Acinetobacter rare(17.07%); gram positive bacteria 19 strains(23.17%), Staphylococcus aureus(12.20%) was more common; 9 strains of fungi (10.98%), with candida albicans(7.32%). Meropenem, imipenem, amikacin, ciprofloxacin, cefoperazone/sulbactam resistance rate of Pseudomonas aeruginosa was low and Acinetobacter bacteria to meropenem, imipenem, cefoperazone/sulbactam aztreonam, levofloxacin resistance rate was low, pneumonia Cray Borrelia bacteria to meropenem, imipenem and levofloxacin, ciprofloxacin resistance rate was low.The sensitivity of Staphylococcus aureus to vancomycin and linezolid without resistance to teicoplanin, imipenem resistant rate was low.The mortality rates of ventilator less than 4h and more than 4h were 56.25%, 43.75%, the difference was not statistically significant (χ2=2.64, P>0.05), but the mortality rate of de-escalation therapy was 19.35%, which was significantly lower than 43.48% of rose escalation therapy(χ2=8.54, P<0.05). Conclusion Gram negative bacteria infection in COPD patients combined with VAP is the main infection and pathogens to antimicrobial drug resistance higher.Therefore, the control of nosocomial infection should be strengthen, according to the etiology for the rational use of antimicrobial drugs, and clinical de-escalation therapy can reduce the mortality. Key words: Pulmonary disease, chronic obstructive; Pneumonia, ventilator-associated; Pathogen; Bacteria