[Analysis on the clinical pulmonary infection score on the detection of multidrug resistance organisms in lower respiratory tract in ventilated patients in intensive care unit].

Abstract

Objective: To investigate the characteristics of multidrug resistance (MDR) organisms from the lower respiratory tract in ventilated patients, and the constitution, detection time and mortality of the intensive care unit (ICU) patients with different clinical pulmonary infection scores (CPIS).

Methods: A retrospective study was conducted. The clinical data of 72 cases with lower respiratory tract MDR on ventilation more than 48 hours were collected from April 2010 to December 2011. CPIS were calculated at the same time. Thirty-three patients with CPIS>6 were diagnosed as ventilation associated pneumonia (VAP), while 39 having CPIS ≤6 (non-VAP). The characteristics of MDR, the detection time and mortality of the patients were compared between the two groups.

Results: The first five MDR were Baumannii [49.5%(34/74)], Klebsiella pneumoniae [24.3%(18/74)], Escherichia coli [20.3%(15/74)], Pseudomonas aeruginosa [5.4%(4/74)] and Methicillin-resistant Staphylococcus aureus [MRSA, 4.1%(3/74)] in VAP group, while the first five were Escherichia coli [40.2%(37/92)], Pseudomonas aeruginosa [33.7%(31/92)], Klebsiella pneumoniae [13.1%(12/92)], Baumannii [8.7%(8/92)] and MRSA [4.3%(4/92)] in non-VAP group. There was no significant difference in average detection time between VAP group and non-VAP group (10.7±1.5 days vs. 9.4±1.8 days, P>0.05). The mortality rate in VAP group was significantly higher than that in non-VAP group (39.4% vs. 23.1%, P<0.05).

Conclusions: Different MDR may be detected in lower respiratory tracts no matter the ventilated patients having VAP or not, which influence the patients prognosis and should be monitored intensively. Antibiotics should be empirically prescribed and adjusted dynamically.