Epidemiological characteristics of ventilator-associated pneumonia in neurosurgery:A 10-year surveillance study in a Chinese tertiary hospital  

作　　者：Zhenghao Yu Xinlou Li Chenglong Lv Yao Tian Jijiang Suo Zhongqiang Yan Yanling Bai Bowei Liu Liqun Fang Mingmei Du Hongwu Yao Yunxi Liu 

机构地区：[1]Department of Disease Prevention and Control,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China [2]Medical School of Chinese PLA,Beijing 100853,China [3]Department of Medical Research,Key Laboratory of Environmental Sense Organ Stress and Health of the Ministry of Environmental Protection,the Ninth Medical Center,Chinese PLA General Hospital,Beijing 100101,China [4]State Key Laboratory of Pathogen and Biosecurity,Beijing Institute of Microbiology and Epidemiology,Beijing 100071,China

出　　处：《Infectious Medicine》2024年第3期1-9,共9页感染医学（英文）

基　　金：Youth-Support Project of Chinese PLA General Hospital(QNF19044);Project on Bio-Safety Control and Prevention(2020-YJXTGCWQS-X9288).

摘　　要：Background Ventilator-associated pneumonia(VAP)is a significant and common health concern.The epidemiological landscape of VAP is poorly understood in neurosurgery patients.This study aimed to explore the epidemiology of VAP in this population and devise targeted surveillance,treatment,and control efforts.Methods A 10-year retrospective study spanning 2011 to 2020 was performed in a large Chinese tertiary hospital.Surveillance data was collected from neurosurgical patients and analyzed to map the demographic and clinical characteristics of VAP and describe the distribution and antimicrobial resistance profile of leading pathogens.Risk factors associated with the presence of VAP were explored using boosted regression tree(BRT)models.Results Three hundred ten VAP patients were identified.The 10-year incidence of VAP was 16.21 per 1000 ventilation days.All-cause mortality was 6.1%.The prevalence of gram-negative bacteria,fungi,and gram-positive bacteria among the 357 organisms isolated from VAP patients was 86.0%,7.6%,and 6.4%,respectively;most were multidrug-resistant organisms.Acinetobacter baumannii,Klebsiella pneumoniae,and Pseudomonas aeruginosa were the most common pathogens.The prevalence of carbapenem-resistant A.baumannii,P.aeruginosa,and K.pneumoniae was high and increased over time in the study period.The BRT models revealed that VAP was associated with number of days of ventilator use(relative contribution,47.84±7.25),Glasgow Coma Scale score(relative contribution,24.72±5.67),and tracheotomy(relative contribution,21.50±2.69).Conclusions Our findings provide a better understanding of the epidemiology of VAP and its risk factors in neurosurgery patients.

关 键 词：Mechanical ventilation pneumonia Epidemiological characteristic NEUROSURGERY Multi-drug resistance Risk factor 

分 类 号：R563.1[医药卫生—呼吸系统]