Immune imbalance markers: key factors in early recognition of multidrug-resistant bacterial infections in non-immunocompromised VAP patients

BackgroundResearch on the role of immune dysregulation in multidrug-resistant organism (MDRO) infections among patients with ventilator-associated pneumonia (VAP) remains limited, and there is a lack of reliable immunological indicators for early identification.MethodsWe conducted a retrospective analysis of 247 non-immunocompromised patients who developed VAP following mechanical ventilation in the Neurointensive Care Unit (NICU). Patients were categorized into MDRO and non-MDRO groups based on the presence or absence of MDRO infection.

Binary logistic regression with sequential adjustment (three models), subgroup analyses, and receiver operating characteristic (ROC) curve analysis were used to evaluate associations between MDRO infection and early-stage (within 72 hours) immunological indicators, including IL-10, IL-17A, IL-6, and T-cell parameters (CD4+, CD8+, CD3+ counts, and CD4/CD8 ratio). Additionally, six pathogen-specific subgroups were analyzed to assess differences in immune factor levels across pathogen types.ResultIn univariate analysis, T-cell parameters showed no statistical significance, but IL-10 and IL-6 levels were significantly elevated in the MDRO group.

In the fully adjusted logistic regression model, IL-10 and IL-6 were identified as independent risk factors. Higher IL-10 tertiles showed a dose-response relationship with MDRO risk.