Objective:

To explore indicators of immune dysregulation associated with multidrug-resistant organism (MDRO) infections in patients with ventilator-associated pneumonia (VAP) and their significance for early detection.

Key Findings:

• IL-10 and IL-6 levels were significantly elevated in the MDRO group, indicating potential biomarkers for early detection.
• IL-10 and IL-6 were identified as independent risk factors for MDRO infection, suggesting their role in patient management.
• Higher IL-10 tertiles showed a dose-response relationship with MDRO risk, emphasizing the need for monitoring IL-10 levels.
• Serum IL-6 levels were significantly higher in patients with ESBL-KP infection compared to those with CRAB infection, indicating pathogen-specific immune responses.
• IL-10 levels did not differ significantly across MDRO subgroups, indicating a universal immune response that may complicate treatment strategies.

Interpretation:

Elevated serum IL-10 and IL-6 levels within 72 hours of VAP onset indicate immune dysregulation and may facilitate early identification of patients at risk for MDRO infection, potentially guiding therapeutic interventions.

Limitations:

• Retrospective design may limit causality inference and introduce selection bias.
• Study conducted in a single NICU may affect generalizability to other settings.

Conclusion:

Serum IL-10 levels may serve as an independent biomarker for immune dysregulation, while IL-6 levels may indicate a specific immune response to certain MDRO strains, highlighting their potential utility in clinical practice.