An Analysis Of Clinical Risk Factors And Prevent In Neonatal Ventilator-associated Pneumonia

OBJECTIVETo analyse the clinical characteristics of ventilator-associated pneumonia in neonatal intensive care unit and to investigate the risk factors and the pathogenic bacteria detection in neonatal ventilator-associated pneumonia.METHODSAn retrospective analysis of clinical data of 250 newborns with mechanical ventilation>48 hours was done. To investigate the correlation of the duration of mechanical ventilation, gestational ages, birth weights, delivery mode, premature rupture of fetal membranes, amniotic fluid, Apgar, basic disease, mechanical ventilation mode, use of PS, jejunitas, intravenous nutrition, antibiotics and probiotics with neonatal ventilator-associated pneumonia.RESULTSThe incidence rate of neonatal ventilator-associated pneumonia was 58.4%. Univariateanalysis showed that there were significantly difference for the gestational age, birth weights, delivery mode, basic disease, duration of mechanical ventilation, intravenous nutrition, antibiotics and probiotics in neonatal ventilator-associated pneumonia and non-ventilator-associated pneumonia(P<0.05), and there were no significantly difference for the other factors(P>0.05). Multivariate stepwise logistic regression analysis showed that the duration of mechanical ventilation and basic disease was positive correlation with neonatal ventilator-associated pneumonia and the gestational age, probiotics was negative correlation with neonatal ventilator-associated pneumonia. The main pathogens were G-bacilli. Klebsiella pneumonia, bawmanii, et al were the most common bacteria. They were highly tolerant to many antibiotics.CONCLUSIONSThe VAP incidence rate is high in the NICU. VAP is influenced by many factors, and the main pathogens for VAP are Gram-negative bacteria, the multi-drug resistance is severe. It’s necessary to reasonable application of antibiotics, and take comprehensive measures to preventing NVAP.