Etiology And High Risk Factors For Ventilator-associated Pneumonia In Neonates

Objective: To explore the preventions and treatments of ventilator-associated pneumonia(VAP),we analyzed the characters, etiology and high risk factors of VAP in neonates in the neonatal intensive care unit. Methods: A retrospective study was conducted at the No.1 affiliated hospital of Jiangxi Medical College on 84 patients who had the hours of mechanical ventilation≥48h and admitted to the NICU from June.2002 to Mar.2005. Among the patients, mechanically ventilated neonates who suffered VAP were included in a case group, and non-VAP neonates were in a control group. Case-control method and multiple logistic regression was performed to determine risk factors such as gender, gestation age, birth weight, ventilation hour, drugs,and so on. At the same time, we analyzed the results of tracheal aspirates cultures and drug sensitivity test in VAP neonates to determine pathogenic microorganism and the severity of drug fast. Results: Among 106 mechanical ventilation patients, eighty-four had MV hours ≥48h and thirty-five VAP(41.7%) occurred. The primary pathogenic bacterium of VAP is Gram-negative bacilli, and VAP resists to several kinds of bacteria. MV hour, original disease,re-intubation, prematurity, low birth weight and drugs were factors for VAP, but gender, age, and delivery way do not correlate with VAP. Conclusion: The primary pathogenic bacterium of VAP is Gram-negative bacilli, and VAP resists to several kinds of bacteria. The etiology of VAP is complex. All measures are needed to treat and prevent VAP.