探索呼吸机相关肺炎:一项回顾性研究的微生物线索和生物标志物启示。

IF 2.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Ahmed M Gouda, Ashraf E Sileem, Hanan M Elnahas, Ahmed E Tawfik, Refaat A Eid, Ayed A Shati, Saleh M Al-Qahtani, Samy A Dawood, Mohammed A Alshehri, Mohamed Eissa, Mohamed A Soltan, Ahmed E Noreldin, Amir Helmy Elwishahy, Essamedin M Negm
{"title":"探索呼吸机相关肺炎:一项回顾性研究的微生物线索和生物标志物启示。","authors":"Ahmed M Gouda, Ashraf E Sileem, Hanan M Elnahas, Ahmed E Tawfik, Refaat A Eid, Ayed A Shati, Saleh M Al-Qahtani, Samy A Dawood, Mohammed A Alshehri, Mohamed Eissa, Mohamed A Soltan, Ahmed E Noreldin, Amir Helmy Elwishahy, Essamedin M Negm","doi":"10.3390/medicina60081346","DOIUrl":null,"url":null,"abstract":"<p><p><i>Background and Objectives</i>: Ventilator-associated pneumonia (VAP) is a common complication in critically ill patients receiving mechanical ventilation. The incidence rates of VAP vary, and it poses significant challenges due to microbial resistance and the potential for adverse outcomes. This study aims to explore the microbial profile of VAP and evaluate the utility of biomarkers and illness severity scores in predicting survival. <i>Materials and Methods</i>: A retrospective cohort study was conducted involving 130 patients diagnosed with VAP. Microbial analysis of bronchoalveolar lavage (BAL) fluid, as well as measurements of C-reactive protein (CRP) and procalcitonin (PCT) levels, were performed. Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were calculated to assess illness severity. Statistical analyses were conducted to determine correlations and associations. <i>Results</i>: The study revealed that <i>Klebsiella pneumoniae</i> (<i>K. pneumoniae</i>) (50.7%) and <i>Pseudomonas aeruginosa</i> (<i>P. aeruginosa</i>) (27.69%) were the most identified microorganisms in VAP cases. SOFA (<i>p</i>-value < 0.0001) and APACHE II (<i>p</i>-value < 0.0001) scores were effective in assessing the severity of illness and predicting mortality in VAP patients. Additionally, our investigation highlighted the prognostic potential of CRP levels (odds ratio [OR]: 0.980, 95% confidence interval [CI] 0.968 to 0.992, <i>p</i> = 0.001). Elevated levels of CRP were associated with reduced survival probabilities in VAP patients. Conclusion: This study highlights the microbial profile of VAP and the importance of biomarkers and illness severity scores in predicting survival. <i>Conclusions</i>: The findings emphasize the need for appropriate management strategies to combat microbial resistance and improve outcomes in VAP patients.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":null,"pages":null},"PeriodicalIF":2.4000,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356324/pdf/","citationCount":"0","resultStr":"{\"title\":\"Exploring Ventilator-Associated Pneumonia: Microbial Clues and Biomarker Insights from a Retrospective Study.\",\"authors\":\"Ahmed M Gouda, Ashraf E Sileem, Hanan M Elnahas, Ahmed E Tawfik, Refaat A Eid, Ayed A Shati, Saleh M Al-Qahtani, Samy A Dawood, Mohammed A Alshehri, Mohamed Eissa, Mohamed A Soltan, Ahmed E Noreldin, Amir Helmy Elwishahy, Essamedin M Negm\",\"doi\":\"10.3390/medicina60081346\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><i>Background and Objectives</i>: Ventilator-associated pneumonia (VAP) is a common complication in critically ill patients receiving mechanical ventilation. The incidence rates of VAP vary, and it poses significant challenges due to microbial resistance and the potential for adverse outcomes. This study aims to explore the microbial profile of VAP and evaluate the utility of biomarkers and illness severity scores in predicting survival. <i>Materials and Methods</i>: A retrospective cohort study was conducted involving 130 patients diagnosed with VAP. Microbial analysis of bronchoalveolar lavage (BAL) fluid, as well as measurements of C-reactive protein (CRP) and procalcitonin (PCT) levels, were performed. Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were calculated to assess illness severity. Statistical analyses were conducted to determine correlations and associations. <i>Results</i>: The study revealed that <i>Klebsiella pneumoniae</i> (<i>K. pneumoniae</i>) (50.7%) and <i>Pseudomonas aeruginosa</i> (<i>P. aeruginosa</i>) (27.69%) were the most identified microorganisms in VAP cases. SOFA (<i>p</i>-value < 0.0001) and APACHE II (<i>p</i>-value < 0.0001) scores were effective in assessing the severity of illness and predicting mortality in VAP patients. Additionally, our investigation highlighted the prognostic potential of CRP levels (odds ratio [OR]: 0.980, 95% confidence interval [CI] 0.968 to 0.992, <i>p</i> = 0.001). Elevated levels of CRP were associated with reduced survival probabilities in VAP patients. Conclusion: This study highlights the microbial profile of VAP and the importance of biomarkers and illness severity scores in predicting survival. <i>Conclusions</i>: The findings emphasize the need for appropriate management strategies to combat microbial resistance and improve outcomes in VAP patients.</p>\",\"PeriodicalId\":49830,\"journal\":{\"name\":\"Medicina-Lithuania\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-08-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356324/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medicina-Lithuania\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3390/medicina60081346\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medicina-Lithuania","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/medicina60081346","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

摘要

背景和目的:呼吸机相关肺炎(VAP)是接受机械通气的重症患者常见的并发症。VAP 的发病率各不相同,由于微生物的耐药性和潜在的不良后果,它带来了巨大的挑战。本研究旨在探索 VAP 的微生物特征,并评估生物标记物和病情严重程度评分在预测存活率方面的效用。材料与方法:研究人员对 130 名确诊为 VAP 的患者进行了回顾性队列研究。研究人员对支气管肺泡灌洗液(BAL)进行了微生物分析,并测量了 C 反应蛋白(CRP)和降钙素原(PCT)水平。计算序列器官衰竭评估(SOFA)和急性生理学与慢性健康评估 II(APACHE II)评分,以评估疾病的严重程度。进行统计分析以确定相关性和关联性。结果研究显示,肺炎克雷伯菌(K. pneumoniae)(50.7%)和铜绿假单胞菌(P. aeruginosa)(27.69%)是在 VAP 病例中发现最多的微生物。SOFA(p-value < 0.0001)和 APACHE II(p-value < 0.0001)评分能有效评估 VAP 患者的病情严重程度并预测死亡率。此外,我们的调查还强调了 CRP 水平的预后潜力(几率比 [OR]:0.980,95% 置信区间 [CI] 0.968 至 0.992,P = 0.001)。CRP 水平升高与 VAP 患者生存概率降低有关。结论本研究强调了 VAP 的微生物特征以及生物标志物和疾病严重程度评分在预测存活率方面的重要性。结论研究结果强调,需要采取适当的管理策略来对抗微生物耐药性并改善 VAP 患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exploring Ventilator-Associated Pneumonia: Microbial Clues and Biomarker Insights from a Retrospective Study.

Background and Objectives: Ventilator-associated pneumonia (VAP) is a common complication in critically ill patients receiving mechanical ventilation. The incidence rates of VAP vary, and it poses significant challenges due to microbial resistance and the potential for adverse outcomes. This study aims to explore the microbial profile of VAP and evaluate the utility of biomarkers and illness severity scores in predicting survival. Materials and Methods: A retrospective cohort study was conducted involving 130 patients diagnosed with VAP. Microbial analysis of bronchoalveolar lavage (BAL) fluid, as well as measurements of C-reactive protein (CRP) and procalcitonin (PCT) levels, were performed. Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were calculated to assess illness severity. Statistical analyses were conducted to determine correlations and associations. Results: The study revealed that Klebsiella pneumoniae (K. pneumoniae) (50.7%) and Pseudomonas aeruginosa (P. aeruginosa) (27.69%) were the most identified microorganisms in VAP cases. SOFA (p-value < 0.0001) and APACHE II (p-value < 0.0001) scores were effective in assessing the severity of illness and predicting mortality in VAP patients. Additionally, our investigation highlighted the prognostic potential of CRP levels (odds ratio [OR]: 0.980, 95% confidence interval [CI] 0.968 to 0.992, p = 0.001). Elevated levels of CRP were associated with reduced survival probabilities in VAP patients. Conclusion: This study highlights the microbial profile of VAP and the importance of biomarkers and illness severity scores in predicting survival. Conclusions: The findings emphasize the need for appropriate management strategies to combat microbial resistance and improve outcomes in VAP patients.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Medicina-Lithuania
Medicina-Lithuania 医学-医学:内科
CiteScore
3.30
自引率
3.80%
发文量
1578
审稿时长
25.04 days
期刊介绍: The journal’s main focus is on reviews as well as clinical and experimental investigations. The journal aims to advance knowledge related to problems in medicine in developing countries as well as developed economies, to disseminate research on global health, and to promote and foster prevention and treatment of diseases worldwide. MEDICINA publications cater to clinicians, diagnosticians and researchers, and serve as a forum to discuss the current status of health-related matters and their impact on a global and local scale.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信