PDF(Pubmed)
Abstract：
Purpose: 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. Method: 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. Results: 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. Conclusion: 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.
摘要：
目的:通过分析临床特点,重症监护病房（ICU）呼吸机相关性肺炎（VAP）患者的病原学特征和常用抗生素。本研究旨在为VAP患者的临床合理用药提供指导信息。方法：从重症监护医学信息集市（MIMIC-IV）数据库中收集有VAP信息的患者，包括他们的社会人口特征，生命体征,实验室测量，并发症,微生物学,抗生素的使用。经过数据处理,使用统计图表和表格描述了ICU中VAP患者使用的药物特征，总结了经验,分析了原因。结果：本研究纳入2,068例VAP患者。48个病人特征,包括人口指标，生命体征,生化指标,分数,和合并症，比较VAP患者的生存和死亡情况。最常用的是头孢菌素和万古霉素。其中,第四代头孢菌素（ForGC）联合万古霉素使用最多，540名患者第一代49n头孢菌素（FirGC）联合万古霉素的存活率最高（86.7％）。超过55％的患者感染了革兰氏阴性菌。然而,VAP患者的耐药菌株较少(<25%).FirGC或ForGC联合万古霉素具有许多与炎症相关的特征，与未接受药物治疗的患者有显著不同。结论：了解抗生素的使用，病原菌组成，VAP患者的耐药率有助于预防疾病的发生,尽快控制感染，促进患者康复。
