Objective

To determine the utility of microscopic examination and culture of endotracheal aspirate (ETA) in the early diagnosis of ventilator-associated pneumonia (VAP) in preterm neonates.

Methods

We enrolled 80 consecutive neonates (both inborn and out-born) with gestational age of < 37 weeks admitted in Special Newborn Care Unit (SNCU) and requiring mechanical ventilation (MV) for > 48 hours. The diagnosis of VAP was made using the criteria laid down by the Centers for Disease Control (CDC).

Results

47 preterm neonates (58.5%) developed VAP; the overall incidence was 74.7/1000 ventilator-days. The mean (SD) time (hours) to ETA culture was less as compared to diagnosis based on CDC criteria [108.9 (8.00 hrs) vs 132.4 (53.24); P = 0.004] with sensitivity and specificity of 80.8% and 72.7%, respectively. Outborn delivery was the single most important risk factor for VAP. Multidrug resistant (MDR) Klebsiella pneumoniae (63.9%) was the most prevalent organism.

Conclusions

We noticed a very high incidence of VAP among preterm neonates in SNCU. ETA culture can aid in early diagnosis.

中文翻译：

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特殊新生儿护理病房收治的早产儿呼吸机相关肺炎的早期预测因素

客观的

确定显微镜检查和气管内抽吸物（ETA）培养在早产儿呼吸机相关性肺炎（VAP）早期诊断中的效用。

方法

我们连续招募了 80 名胎龄 < 37 周的新生儿（包括出生的和出生的），入住特殊新生儿护理病房 (SNCU)，需要机械通气 (MV) > 48 小时。VAP 的诊断是根据疾病控制中心 (CDC) 制定的标准进行的。

结果

47 名早产儿（58.5%）出现 VAP；总体发生率为 74.7/1000 个呼吸机天。与基于 CDC 标准的诊断相比，ETA 培养的平均 (SD) 时间（小时）较短 [108.9（8.00 小时）vs 132.4（53.24）；P = 0.004 ] 敏感性和特异性分别为 80.8% 和 72.7%。出生时分娩是 VAP 的一个最重要的危险因素。多重耐药 (MDR)肺炎克雷伯菌(63.9%) 是最常见的微生物。

结论

我们注意到 SNCU 早产儿 VAP 的发病率非常高。ETA 培养有助于早期诊断。