An Analysis Of Risk Factors And Pathogens In Neonatal Refractory Pneumonia

OBJECTIVE:To investigate the risk factors and the pathogenic bacteria detection in neonatal refractory pneumonia.METHODS:A case-control study method was used, the clinical data of78cases of neonatal refractory pneumonia and85cases with neonatal pneumonia in general at the same time in hospital were retrospectively analyzed. To analyze the risk factors of neonatal refractory pneumonia, bacteria distribution and drug resistance characteristic of pathogens.RESULTS:The incidence rate of refractory pneumonia was1.78%. Univariateanalysis showed that there were significantly difference for the premature rupture of membranes, gastric tube feeding, intensive care, oxygen inhalation, tracheal intubation/sputum suction, Apgar score in the two groups (P<0.05); and there were no significantly difference for gender, gestational ages, birth weight, the character of amniotic fluid, parenteral nutrition (P>0.05). Multivariate stepwlse logistic regression analysis showed that intensive care, tracheal intubation/sputum suction, Apgar score were positive correlation with refractory pneumonia (OR=8.881, CI=1.666～46.593, P=0.010;OR=7.798, CI=2.333～26.061, P=0.001;OR=3.287, CI=1.175～9.916, P=0.023). The main pathogens were G-bacilli. Klebsiella pneumonia and Enterobacter aerogenes were the most common bacterias. They were highly tolerant to many antibiotics, but sensitive to the PiLa Shilling/tazobactam, imipenem, meropenem.CONCLUSIONS:Intensive care, tracheal intubation/sputum suction, Apgar score were the risk factors in refractory pneumonia. The main pathogens are drug—resistant opportunistic bacteria.