Pathogens and risk factors for ventilator-associated pneumonia in neonates.
- Author:
De-Shuang ZHANG
1
;
Chao CHEN
;
Wei ZHOU
;
Juan CHEN
;
De-Zhi MU
Author Information
- Publication Type:Journal Article
- MeSH: Female; Gram-Negative Bacteria; drug effects; isolation & purification; Humans; Infant, Newborn; Logistic Models; Male; Microbial Sensitivity Tests; Pneumonia, Ventilator-Associated; etiology; microbiology; Risk Factors
- From: Chinese Journal of Contemporary Pediatrics 2013;15(1):14-18
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo study the pathogens, drug sensitivity and risk factors for ventilator-associated pneumonia (VAP) in neonates.
METHODSRetrospective analysis was performed on the clinical data of 401 neonates who were admitted to the neonatal intensive care unit and received mechanical ventilation for 48 hours or longer from January 2008 to February 2012. Eighty-five of the 401 neonates suffered VAP.
RESULTSThe main pathogens for VAP were Gram-negative bacteria (97%), including Klebsiella pneumoniae (51%), Acinetobacter baumannii (17%) and Escherichia coli (12%) as the three most frequent ones. The drug sensitivity test showed that these pathogens developed resistance to amoxicillin, amoxicillin/clavulanic acid, piperacillin, ceftazidime, cefazolin, and cefotaxime, with a susceptibility rate of below 15%, and demonstrated decreased sensitivity to imipenem and meropenem, with a susceptibility rate of below 75%. The independent risk factors for neonatal VAP included birth weight (OR=1.399, P<0.05), duration of mechanical ventilation (OR=1.966, P<0.01), length of hospital stay (OR=1.812, P<0.01), times of tracheal intubation (OR=2.056, P<0.01), and 1 min Apgar score (OR=2.146, P<0.01).
CONCLUSIONSThe incidence of neonatal VAP is influenced by many factors. The main pathogens for neonatal VAP are Gram-negative bacteria and antibacterial agents should be properly used according to drug sensitivity test results. Comprehensive prevention and control measures should be taken to reduce the incidence of VAP.