Association between respiratory tract Candida colonization and ventilator-associated pneumonia
OBJECTIVE To explore the association between respiratory tract Candida colonization and ventilator-as-sociated pneumonia(VAP).METHODS A total of 150 patients with bacterial VAP who were treated in the Second People's Hospital of Fuyang City were recruited as the research subjects and were divided into the colonization group with 67 cases and the non-colonization group with 83 cases according to the status of respiratory tract Can-dida colonization.The isolation rates of bacteria strains from respiratory tract secretions and the levels of serum amyloid A(SAA)protein,C-reactive protein(CRP)and interleukin-6(IL-6)in respiratory tract secretions were compared between the two groups.The association between the levels of SAA,CRP and IL-6 and the clinical inde-xes of the colonization group was observed,and the value of the indexes in diagnosis of respiratory tract Candida colonization was analyzed.RESULTS The isolation rate of gram-positive bacteria of the colonization group was higher than that of the non-colonization group(P＜0.05).The mechanical ventilation duration of the colonization group was shorter than that of the non-colonization group when VAP was diagnosed(P＜0.05).The percentages of patients with fever,increased volume of sputum and change of sputum characteristic,levels of β-glucan,SAA,CRP and IL-6 in respiratory tract secretions and clinical pulmonary infection score(CPIS)were higher in the colo-nization group than in the non-colonization group(P＜0.05).Pearson related coefficient analysis showed that the levels of SAA,CRP and IL-6 were positively correlated with mechanical ventilation duration,CPIS score and β-glucan of the colonization group when VAP was diagnosed(P＜0.05).Receiver operating characteristic(ROC)curve analysis showed that the areas under curves(AUCs)of SAA,CRP,IL-6 and the joint detection of the three indexes were respectively 0.720,0.723,0.750 and 0.883 in prediction of respiratory tract Candida colonization of the patients with bacterial VAP,and the diagnostic value of the joint detection was higher(P＜0.05).CONCLUSION The respiratory tract Candida colonization may accelerate the progression of illness condition of the patients with bacterial VAP and regulate the immune imbalance by affecting the expressions of SAA,CRP and IL-6,which the bac-terial VAP should be focused on.
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