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| Analysis of antibiotic resistance and prognostic factors of Pseudomonas aeruginosa in patients with chronic obstructive pulmonary disease complicated with ventilator-associated pneumonia |
| ZONG Yugang1 LIU Yanqiu1 FAN Haidi1 YAO Wanqing2 |
1.Department of Clinical Laboratory, Huaian First People’s Hospital Branch Hospital, Jiangsu Province, Huaian 223002, China;
2.Department of Respiratory Medicine, Huaian First People’s Hospital Branch Hospital, Jiangsu Province, Huaian 223002, China
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Abstract Objective To analyze the antibiotic resistance and prognostic factors of Pseudomonas aeruginosa (PA) in patients with chronic obstructive pulmonary disease(COPD) complicated with ventilator-associated pneumonia (VAP). Methods The clinical data of 62 patients with COPD complicated with VAP in the Huaian First People’s Hospital Branch Hospital from June 2019 to June 2022 were retrospectively collected, and the drug resistance of PA to antibiotics was analyzed. According to the clinical outcome within 28 days after admission, the patients were divided into death group (18 cases) and survival group (44 cases). The general data of the two groups were compared, and the influencing factors of prognosis were analyzed by logistic multiple regression. Results A total of 17 strains of PA were cultured from 62 patients with COPD complicated with VAP, the total infection rate was 27.42%, and the drug resistance rate to Ampicillin, Cotrimoxazole, Amtreonam and Cefazolin was more than 90%. The clinical pulmonary infection score (CPIS), neutrophil to lymphocyte ratio.(NLR) and procalcitonin(PCT) levels in the death group were higher than those in the survival group, and the proportion of enteral nutrition support and acid inhibitor use was lower than that in the survival group (P＜0.05). Logistic regression analysis showed that CPIS score, NLR and PCT were risk factors for the prognosis of patients with COPD complicated with VAP, and nutritional support pathway were protective factors (P＜0.05). Conclusion The drug resistance rate of PA in patients with chronic obstructive pulmonary disease complicated with VAP to Ampicillin, Compound Sulfamethoxazole, Amtreonam, and other antibiotics is high, and CPIS score, NLR, PCT, and enteral nutrition support are all factors affecting the prognosis of patients with COPD complicated with VAP.
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