Objective To construct a diagnostic model for screening the influencing factors of multiple drug resistant organism(MDRO)infection in patients with ventilator-associated pneumonia(VAP),and provide guidance information for hospital infection management.Methods One hundred and ninety-four patients with VAP from January 2021 to September 2023 were selected and divided into MDRO group(82 cases)and non-MDRO group(112 cases)according to the results of pathogen culture.Clinical data were collected from both groups,and Lasso-Logistic regression analysis was used to investigate the factors affecting MDRO infec-tion in VAP patients.A diagnostic model for MDRO infection in VAP patients was constructed,and internal validation was performed using calibration curves,ROC curves,and decision curves(DCA).In addition,80 patients with VAP from October 2023 to March 2024 were selected as external validation samples,and ROC curves were used for external validation.Results There were statistically significant differences between the two groups in age,duration of mechanical ventilation,duration of antibiotic use,acute physiology and Chron-ic health status System(APACHE)score,deep vein catheterization,tracheotomy,disturbance of conscious-ness,indindent nasogastral tube,combination of antibiotics,serum C-reactive protein(CRP)and interleukin-6(IL-6)levels(P＜0.05).Lasso-Logistic regression analysis showed that age,mechanical ventilation time,antibacterial drug use time,APACHE score,deep vein catheterization,antibacterial drug combination,indi-ndent nasogastric tube,serum CRP and IL-6 were independent risk factors for VAP and MDRO(P＜0.05).Based on Lasso-Logistic regression analysis,a diagnostic model for MDRO infection in VAP patients was constructed.Internal validation showed that the model had high clinical positive net benefit and diagnostic ef-ficacy.External validation showed that the diagnostic model had reliable diagnostic value.Conclusion The risk factors for VAP with MDRO are age,mechanical ventilation time,antibiotic use time,APACHE score,deep venous catheterization,indwelling nasogastric tube,antibiotic combination,serum CRP,and IL-6.The risk diagnosis model constructed from independent factors has good application value and provides a reference for hospital infection prevention and control and anti-infective treatment.
维普
万方数据
