Yang Rui, Huang Tao, Shen Longbin, Feng Aozi, Li Li, Li Shuna, Huang Liying, He Ningxia, Huang Wei, Liu Hui, Lyu Jun
Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Front Pharmacol. 2022 Jun 13;13:869499. doi: 10.3389/fphar.2022.869499. eCollection 2022.
By analyzing the clinical characteristics, etiological characteristics and commonly used antibiotics of patients with ventilator-associated pneumonia (VAP) in intensive care units (ICUs) in the intensive care database. This study aims to provide guidance information for the clinical rational use of drugs for patients with VAP. Patients with VAP information were collected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, including their sociodemographic characteristics, vital signs, laboratory measurements, complications, microbiology, and antibiotic use. After data processing, the characteristics of the medications used by patients with VAP in ICUs were described using statistical graphs and tables, and experiences were summarized and the reasons were analyzed. This study included 2,068 patients with VAP. Forty-eight patient characteristics, including demographic indicators, vital signs, biochemical indicators, scores, and comorbidities, were compared between the survival and death groups of VAP patients. Cephalosporins and vancomycin were the most commonly used. Among them, fourth-generation cephalosporin (ForGC) combined with vancomycin was used the most, by 540 patients. First-generati49n cephalosporin (FirGC) combined with vancomycin was associated with the highest survival rate (86.7%). More than 55% of patients were infected with Gram-negative bacteria. However, patients with VAP had fewer resistant strains (<25%). FirGC or ForGC combined with vancomycin had many inflammation-related features that differed significantly from those in patients who did not receive medication. Understanding antibiotic use, pathogenic bacteria compositions, and the drug resistance rates of patients with VAP can help prevent the occurrence of diseases, contain infections as soon as possible, and promote the recovery of patients.
通过分析重症监护数据库中重症监护病房(ICU)呼吸机相关性肺炎(VAP)患者的临床特征、病因特征和常用抗生素。本研究旨在为VAP患者临床合理用药提供指导信息。从重症监护医学信息集市IV(MIMIC-IV)数据库中收集VAP患者信息,包括社会人口学特征、生命体征、实验室检查结果、并发症、微生物学及抗生素使用情况。数据处理后,采用统计图和表格描述ICU中VAP患者使用药物的特征,并总结经验、分析原因。本研究纳入2068例VAP患者。比较了VAP患者生存组和死亡组之间的48项患者特征,包括人口统计学指标、生命体征、生化指标、评分和合并症。头孢菌素和万古霉素是最常用的。其中,使用第四代头孢菌素(ForGC)联合万古霉素的患者最多,有540例。第一代头孢菌素(FirGC)联合万古霉素的患者生存率最高(86.7%)。超过55%的患者感染革兰氏阴性菌。然而,VAP患者的耐药菌株较少(<25%)。FirGC或ForGC联合万古霉素的患者有许多与炎症相关的特征,与未接受用药的患者有显著差异。了解VAP患者的抗生素使用情况、病原菌组成和耐药率有助于预防疾病发生,尽快控制感染,促进患者康复。