Effect of neutrophil extracellular traps and multidrug resistant bacteria infection on prognosis of patients with severe pneumonia

Objective To explore the effect of neutrophil extracellular traps (NETs) on the multidrug resistance (MDR) bacteria-induced severe pneumonia.

Methods A total of 171 severe pneumonia patients were enrolled and divided into MDR group (n=86) and non-MDR group (n=85). Clinical data and biochemical indices were compared between the two groups. Kaplan-Meier method and Cox proportional hazard model were used to analyze survival rate of patients and predictors.

Results Compared with non-MDR group, the NETs level, SOFA score and APACHE Ⅱ score increased in the MDR group (P < 0.01). NETs level was positively correlated with the SOFA score (r=0.202, P=0.008) and APACHE Ⅱ score (r=0.408, P=0.001). There was significant difference in survival rate between MDR and non-MDR groups (58.48% vs 84.70%, P=0.000 3). Univariate Cox regression analysis showed that NETs affected prognosis of patients with severe pneumonia (HR=1.000 2, 95%CI 1.000 1-1.000 2, P=0.002). Multivariate Cox regression analysis showed that grouping was the independent prognostic factor for survival of patients (HR=0.288, 95%CI 0.151-0.548, P=0.000 1).

Conclusion NETs increase in patients with severe pneumonia induced by MDR bacteria, which may be a factor influencing the prognosis of these patients, and patients with MDR bacteria infection had worse prognosis.