A clinical efficacy study of probiotics on preventing ventilator-associated pneumonia in neonates / 中国小儿急救医学

ABSTRACT

Objective To explore the method that can block the infection route from stomach to lung so as to reduce the incidence of ventilator-associated pneumonia (VAP) in neonates.Methods Neonates with mechanical ventilation were randomly divided into two groups,the treatment group(40 cases) were given probiotics (Bifidobacteria) by nasogastric feeding,control group(40 cases) were given nothing.Prospective survey was performed on the incidence of VAP,gastric juice pH,gastric bacterial colonization,the homology between gastric bacterial colonization and VAP pathogen.Results The VAP incidence of treatment group and control group was 12.5％ (5/40) and 47.5％ (19/40) respectively,there was significant difference between the two groups ( x2 =10.21,P ＜ 0.01 ).The onset time of VAP in treatment group [ ( 5.4 ±2.1 ) d] was later than that of control group[ (4.3 ± 1.0) d] ( t =3.2,P ＜0.01 ).The ratio of treatment group that gastric juice dropped to pH≤3 (80.0％,32/40) was higher than that of control group(47.5％,19/40) ( x2 =11.5,P ＜ 0.01 ) ; and the ratio of gastric bacterial colonization in treatment group ( 30.0％,12/40) was lower than that in control group(80.0％,32/40) ( x2 =16.9,P ＜0.01 ).The homology ratio between VAP pathogen and colonization bacteria in treatment group (40.0％,2/5 ) was lower than that in control group (78.9 ％,15/19 ) ( x2 =8.7,P ＜ 0.01 ).Conclusion Probiotics can reduce gastric juice pH of neonates and inhibit gastric bacterial colonization.The onset time of VAP can be delayed,the incidence of VAP can be reduced effectively.