ventilator-associated pneumonia in hospitalized newborns in a neonatal intensive care unit

Authors

minoo fallahi neonatal health research center (nhrc), shahid beheshti university of medical sciences, tehran, ir iran; shohada-e-tajrish hospital, shahid beheshti university of medical sciences, tehran, ir iran; department of neonatology, shodada-e-tajrish hospital, shahid beheshti university of medical sciences, tehran, ir iran. tel: +98-922718001, fax: +98-22719014سازمان اصلی تایید شده: دانشگاه علوم پزشکی شهید بهشتی (shahid beheshti university of medical sciences)

anahita sanaei dasht professor alborzi clinical microbiology research center, shiraz university of medical sciences, shiraz, ir iranسازمان اصلی تایید شده: دانشگاه علوم پزشکی شیراز (shiraz university of medical sciences)

narjes naeempour shohada-e-tajrish hospital, shahid beheshti university of medical sciences, tehran, ir iranسازمان اصلی تایید شده: دانشگاه علوم پزشکی شهید بهشتی (shahid beheshti university of medical sciences)

mahtafatemeh bassir shohada-e-tajrish hospital, shahid beheshti university of medical sciences, tehran, ir iranسازمان اصلی تایید شده: دانشگاه علوم پزشکی شهید بهشتی (shahid beheshti university of medical sciences)

abstract

background ventilator-associated pneumonia (vap) develops in mechanically ventilated patients 48 hours after putting the patients on the ventilator. vap is the second most common nosocomial infection in neonatal intensive care units (nicu). objectives the current study was conducted to determine the rate, microbiological characteristics and outcome of vap in neonates admitted in the nicu of shohada-e-tajrish hospital. patients and methods: a prospective cross-sectional study was conducted from oct 2009 to sep 2010, on all neonates receiving mechanical ventilation for more than 48h in the nicu. clinical and paraclinical data were documented and tracheal secretions were collected by nonbronchoscopic bronchoalveolar lavage (nb-bal) method for the smear and culture. colony count and antibiograms were done on all culture-positive specimens. results from 103 patients admitted in the nicu, a total of 66 patients were intubated for 48h or more. vap occurred in 33.3% of the mechanically ventilated neonates. microorganisms associated with vap included: klebsiella species in 68.1%, acinetobacter spp. and enterococcus spp. in 13.6%, and candida spp. in 4.5%. lower gestational age and birth weight, longer duration of hospital stay and prolonged ventilator need had a significant relationship with vap. mortality rate was 6.8% in the ventilated infants without vap, while 22.7% of the neonates who developed vap, died. conclusions vap was common in mechanically ventilated infants in the nicu of the hospital and was associated with increased mortality. further studies are needed to investigate the prevention of vap in mechanically ventilated neonates.

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Journal title:
archives of pediatric infectious diseases

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