Analysis Of Influencing Factors And Pathogens Of Ventilator - Associated Pneumonia In Advanced Premature Infants With Respiratory Distress Syndrome

Objective:To discuss the influence factors of ventilator-associated pneumonia (VAP) in late preterm infants with respiratory distress syndrome (RDS)Method:To collect95cases of late preterm infants with RDS who needed ventilator for more than48hours in NICU of Qingdao Women and Children Hospital from January2010to October2013. According to the occurrence of VAP, all subject were divided into VAP group (38cases) and control group (57cases),collect their basic information, record using conditions of respirator, the frequency of tracheal cannula suction, oxygen uptake utilization ratio of PS, write down their blood gas analysis results before ventilator,evaluate disease severity and length of stay of the infants. Logistic regression analysis was performed to determine independent predictors for VAP. The odds ratio (OR) was estimated.Results:①There were no significant differences in gestational age、birth weigh、 cesarean section rate (t/X2为-0.915、1.407、2.542、1.320, P>0.05).②The respiratory distress score and the severity of RDS befor mechanical ventilation were no significant differences (t为-1.364、0.020, P>0.05); The neonatal critical illness score (NCIS) was considered statistically significant (t=3.564, P<0.05).③The ratio of asphyxia and salvage of VAP groupwere higher than control group, the difference were significant (X2=4.06、8.95, P<0.05).④The duration of traction of inspired oxygen (FiO2) that more than0.6、invasive mechanical ventilation time、total mechanical ventilation time in VAP group were longer than control group the difference were significant (t=-2.666、-2.713、-2.684, P<0.05).⑤The ratio of repeated intubationwas considered statistically significant (X2=5.14, P<0.05). ⑥The arterial alveolar oxygen partial pressure ratio (a/A PO2) before mechanical ventilation was considered statistically significant with those of the no complication group (t=-1.757, P<0.05).⑦There were30infants (78.95%) with positive sputumand the main pathogenic bacteria was Gram negative bacilli were found in37(92.5%).⑧The significant relationship was found among repeated intubation, neonatal critical illness score, invasive mechanical ventilation time, length of stay by using Logistic regression analysis (OR=7.630、1.060、1.003、0.018)Conclusions:1.The main factors of VAP in late preterm infant with RDS were repeated intubation, neonatal critical illness score, invasive mechanical ventilation time、length of stay.2.The occurrence of VAP in late preterm infant with RDS had positive correlation with repeated intubation, invasive mechanical ventilation time、length of stay and negative correlation with neonatal critical illness score. Objective:To instigate the distribution and drug resistance of pathogenic bacteria of ventilator-associated pneumonia (VAP) in late preterm infants with respiratory distress syndrome (RDS) in NICU.Method:To collect38late preterm infants with RDS treated in NICU of Qingdao Women and Children Hospital from January2010to October2013who were infected with VAP during mechanical ventilation.Results:①There were30infants (78.95%) with positive sputum. Gram positive bacilli were found in3strains (7.5%) and Gram negative bacilli were found in37(92.5%) strains, Klebsiella pneumonia, pseudomonas aeruginosa and acinetobacter baumannii were the three main pathogenic bacteria.②The positive rate of ESBLs in Klebsiella pneumonia was60%and ESBLs negative strains had higher drug sensitivity than ESBLs strain (X2=3.460-3.800, P<0.05),③There was no ESBLs strains in pseudomonas aeruginosa and acinetobacter baumannii.④They were all sensitive to imipenem and resistance to Cephalosporin antibiotics.Conclusion:Gram negative bacilli are main pathogenic bacteria of VAP in late preterm infants with RDS.