OBJECTIVE To explore the distribution and pathogens isolated from the acute respiratory distress syndrome (ARDS) patients with pulmonary infection and analyze the values of serum endothelial cell-specific molecule-1(ESM-1), soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and macrophage inflammatory protein-1α(MIP-1α) in diagnosis of pulmonary infection.

METHODS A total of 98 ARDS patients complicated with pulmonary infection who were treated in Hebei Provincial People′s Hospital from Oct. 2021 to Oct.2023 were assigned to the infection group, and 102 ARDS patients who were not complicated with pulmonary infection were chosen as the non-infection group. The distribution and drug resistance of the pathogens were analyzed. The levels of serum ESM-1, sTREM-1 and MIP-1α were compared between the two groups, and the values of the three indexes in diagnosis of pulmonary infection in the ARDS patients were analyzed.

RESULTS Totally 112 strains of pathogens were isolated from the patients of the infection group, among which Klebsiella pneumoniae and Staphylococcus aureus were dominant. The drug resistance rates of K.pneumoniae strains to ceftriaxone and cefazolin were 56.52% and 52.17%, respectively; the drug resistance rates of the S.aureus strains to sulfamethoxazole-trimethoprim, clindamycin and oxacillin were 75.00%, 75.00% and 70.00%, respectively. The levels of serum ESM-1, sTREM-1 and MIP-1α of the infection group were higher than those of the non-infection group(P < 0.05); the area under the curve (AUC) value of the joint detection of the three indexes was higher than that of the single detection in diagnosis of the pulmonary infection in the ARDS patients(P < 0.05), and the sensitivity of the joint detection was 93.88%, with the specificity 84.31%.

CONCLUSIONS K.pneumoniae and S.aureus are the predominant species of pathogens isolated from the ARDS patients complicated with pulmonary infection. The patients show the high expressions of serum ESM-1, sTREM-1 and MIP-1α. The joint detection of the three indexes has high value in diagnosis of pulmonary infection in the ARDS patients.