Korean J Pediatr Infect Dis.  2005 May;12(1):67-74. 10.14776/kjpid.2005.12.1.67.

Ventilator-Associated Pneumonia in Neonatal Intensive Care Unit : Clinical Manifestations, Ddiagnostic Availability of Endotracheal Tip Culture

• Kim NY
• Sung TJ
• Shin SH
• Kim SK
• Lee KH
• Yoon HS

• KMID: 2440042
• DOI: http://doi.org/10.14776/kjpid.2005.12.1.67

Abstract

PURPOSE
The incidence of mortality associated with respiratory difficulties is decreasing nowadays contributed to the development of neonatology. However, complications associated with mechanical ventilator are increasing. This study is to determine clinical manifestations, diagnositc availability of the endotracheal tip culture in patients with Ventilator-Associated Pneumonia(VAP) in neonatal intensive care unit(NICU).
METHODS
A retrospective analysis of 50 neonates who were admitted to the NICU of Kangnam Sacred Heart Hospital and had given mechanical ventilator from 1 January 2000 to 30 June 2003. VAP group defined as neonates who had pneumonia with mechanical ventilation longer than 48 hours. They were classified into VAP group(n=13) and control group (n=37) and the prevalence, microorganisms cultured from the endotracheal tube tip and risk factors were investigated.
RESULTS
The prevalence of VAP was 26.0%(n=13) and the most dominant microorganism cultured in our NICU was methicillin-resistant coagulase negative staphylococcus(MRCNS) in 4 cases. Other microorganisms were Pseudomonas, Enterobacter, methicillin-resistant Staphylococcus aureus(MRSA) and Klebsiella. Gestational age, birth weight, Apgar score, respiratory distress syndrome, retinopathy of prematurity, bronchopulmonary dysplasia, sepsis, renal failure, pulmonary hemorrhage, pneumothorax were not different significantly between two groups except intraventricular hemorrhage(P < 0.001) and patent ductus arteriosus(P < 0.05). Duration of hospital stay and mortality rate were also not different significantly.
CONCLUSION
VAP occurred at a significant rate among mechanically ventilated NICU patients. Despite of limitation of encotracheal tip culture, the most common microorganism was MR-CNS. We should be aware of occurrence of VAP in NICU neonate who were with mechanical ventilator and should treat with great care.

Keyword

Ventilator-associated pneumonia; Neonatal intensive care unit(NICU); Endotracheal tube tip culture

MeSH Terms

Apgar Score
Birth Weight
Bronchopulmonary Dysplasia
Coagulase
Enterobacter
Gestational Age
Heart
Hemorrhage
Humans
Incidence
Infant, Newborn
Intensive Care, Neonatal*
Klebsiella
Length of Stay
Methicillin Resistance
Mortality
Neonatology
Pneumonia
Pneumonia, Ventilator-Associated*
Pneumothorax
Prevalence
Pseudomonas
Renal Insufficiency
Respiration, Artificial
Retinopathy of Prematurity
Retrospective Studies
Risk Factors
Sepsis
Staphylococcus
Ventilators, Mechanical
Coagulase