OBJECTIVE To explore the distribution of pathogens and the evaluation of inflammatory response in patients with ventilator-associated pneumonia (VAP). METHODS 131 patients with mechanical ventilation who were treated in the hospital from Nov. 2015 to Nov. 2017 were enrolled. The data of age, gender, BMI, underlying diseases and serum inflammatory factors were collected and analyzed retrospectively. The diagnostic values of serum C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-αlpha) and procalcitonin (PCT) in patients with VAP were explored. RESULTS Infection was detected in 74 of the 131 patients with mechanical ventilation, and the infection rate was 56.49%. A total of 96 pathogens were cultured from the samples collected from the 74 infected patients, which were mainly gram-negative bacteria, followed by gram-positive bacteria and fungi. The concentrations of serum CRP, PCT, IL-6, IL-10 and TNF-α in the infected group were higher than those in the uninfected group (P<0.05). When the concentrations of serum CRP, PCT, IL-6 , IL-10 and TNF-α were used to diagnose the infection in the mechanical ventilation patients, the optimal cutoff values were 10.75 mg/L, 0.59 μg/L, 0.68 pg/ml, 0.71 pg/ml. 0.59 pg/ml, and the Yoden index values were 50.77%, 58.77%, 50.87%. 50.10%, 59.00%. CONCLUSION A variety of pathogens can lead to infection in patients who use mechanical ventilation, of which the proportion of gram-negative bacteria is relatively high. Serum C-reactive protein, interleukin -6 , tumor necrosis factor - alpha and calcitonin have a certain diagnostic value in the occurrence of infection in patients with mechanical ventilation. However, the diagnostic value of single index is relatively limited, and we should combine multiple indicators and the actual clinical situation of patients during the diagnosis.
Chinese Journal of Nosocomiology