Ventilator Associated Pneumonia in Critically-Ill Neonates Admitted To Neonatal Intensive Care Unit, Zagazig University Hospitals

Gahda Amr; Mohamed Beshir; Ehab Albanna; Yasser Ali; Mohamed Badr

IJ Pediatrics

The Scientific Journal of Growth & Development Research Center

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Ventilator Associated Pneumonia in Critically-Ill Neonates Admitted To Neonatal Intensive Care Unit, Zagazig University Hospitals

Author(s):

Gahda Amr¹,

Mohamed Beshir¹,

Ehab Albanna¹,

Yasser Ali¹,

Mohamed Badr^1,*

1Departments of Pediatrics and Clinical pathology, Faculty of Medicine, Zagazig University, Egypt

IJ Pediatrics:Vol. 21, issue 4; 418-424

Published online:Dec 31, 2011

Article type:Research Article

Received:Oct 02, 2010

Accepted:Jul 16, 2011

How to Cite:Gahda AmrMohamed BeshirEhab AlbannaYasser AliMohamed BadrVentilator Associated Pneumonia in Critically-Ill Neonates Admitted To Neonatal Intensive Care Unit, Zagazig University Hospitals.Iran J Pediatr.21(4):418-424.

Abstract

Objective: ventilator associated pneumonia (VAP) is defined as nosocomial pneumonia in mechanically ventilated patients. It is considered to be most important cause of infection-related death in intensive care unit. We studied the characteristics and risk factors of VAP in critically-ill neonates.
Methods: Fifty six consecutive neonates with different diagnosis admitted from January to October 2010 to neonatal intensive care unit (NICU), Zagazig University Hospitals who needed mechanical ventilation were included in the study. There were 32 neonates, 18 males and 14 females with proven diagnosis of VAP, and 24 neonates, 11 males and 13 females without VAP served as control group. All studied neonates were subjected to history taking, clinical examination, routine investigations (Complete blood count, C-reactive protein, arterial blood gases, blood culture and liver and kidney function tests), and chest X-ray daily as well as non-bronchoscopic alveolar lavage culture for VAP group only.
Findings: Of 56 neonates who needed mechanical ventilation, 57.1% developed VAP. Prematurity, low birth weight and prolonged duration of mechanical ventilation were risk factors for developing VAP. Increased total leucocytic count, CRP and hypoalbuminemia were significantly presented in VAP-group. There were significant differences between VAP and non-VAP groups regarding hypothermia, mucopurulent endotracheal tube secretion, PaCO2 and PaO2. Microorganisms associated with blood stream infection in VAP diagnosed group were Klebsiella (15.6%), S. aureus (12.5%), Pseudomonas (9.4%), E. coli (6.2%), Candida (3.1%); 53.1% of obtained blood cultures were sterile. Of non-bronchoscopic alveolar lavage cultures obtained from VAP patients, 68.6% showed gram negative infection, 21.8% showed gram positive organisms and 9.3% revealed Candida infection.
Conclusion: The most important risk factors of VAP are prematurity, low birth weight, prolonged duration of mechanical ventilation, enteral nutrition and umbilical catheterization.

Keywords

Ventilator Associated Pneumonia

Neonate

Neonatal Intensive Care Unit

low birth weight

Prematurity

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