Characteristics and risk factors of neonates with ventilator-associated pneumonia in neonates / 中国小儿急救医学

ABSTRACT

Objective To determine the prevalence, characteristics, risk factors, and outcomes of ventilator-associated pneumonia (VAP) in neonates. Methods Data were collected retrospectively among neonates admitted to NICU in St. Louis Children's Hospital in Washington University School of Medicine between January 1,2005 and December 31,2006. Results A total of 682 patients were mechanically ventilated and 79 episodes of VAP occurred in 527 patients who were mechanically ventilated for more than or equal to 48 h. VAP prevalence were 6. 3,5. 8,5.6, and 3.6 per 1 000 ventilator days for patients with birth weight ≤1 000 g, 1 001～1 500 g, 1 501～2 500 g, and＞2 500 g, respectively. By multivariate logistic regression analysis, smaller gestational age and longer duration of mechanical ventilation were found to be predictive of VAP (odds ratio0. 886 and 1. 037;95% confidence interval0. 839～0. 943 and 1.027～1.046). Patients with VAP had prolonged length of stay in NICU [ (103.6 4±69. 1) d vs (42. 8 ±46. 5) d]. Gram-negative bacilli were the most commonly isolated organisms (86. 09%). Conclusion VAP occurred at higher rates in neonates with smaller gestational age and might be associated with increased length of stay. Developing a standardized assessment of readiness to wean mechanical ventilatory support would be useful in this patient population.