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}
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.
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.