Analysis in incidence, pathogen characteristics and influencing factors of neonatal ventilator-associated pneumonia

  Objective  To analyze the incidence, pathogen characteristics and influencing factors of neonatal ventilator-associated pneumonia (VAP).

  Methods  A total of 192 neonates from January 2018 to October 2021 in Yancheng Maternal and Child Health Hospital of Jiangsu Province were selected as study subjects. The clinical data were collected and the incidence of VAP was analyzed. Sputum pathogen was examined in children with VAP, and the distribution of pathogens was analyzed. Univariate and multivariate Logistic regression analysis were performed on the influencing factors of neonatal VAP.

  Results  VAP occurred in 24 of 192 neonates who underwent mechanical ventilation, and the incidence of VAP was 12.50%. A total of 29 strains were isolated from 24 VAP neonates, of which Gram-negative and Gram-positive strains accounted for 72.41% and 27.59%, respectively. In Gram-negative bacteria, Klebsiella pneumoniae accounted for the highest proportion (27.59%). In Gram-positive bacteria, Staphylococcus aureus accounted for the highest proportion (13.79%). There were no significant differences in gender and delivery mode between VAP and non-VAP children (P>0.05). There were significant differences in gestational age, birth weight, Apgar score at 1min after birth, albumin level, primary diseases, bedside elevation, re-intubation after weaning failure, sputum aspiration mode and mechanical ventilation time between VAP and non-VAP children (P < 0.05). Multivariate Logistic regression analysis showed that gestational age, birth weight, Apgar score at 1 minute after birth, albumin level, bedside elevation, intubation after weaning failure, sputum aspiration method and mechanical ventilation time were the influential factors for the occurrence of neonatal VAP (P < 0.05).

  Conclusion  The incidence of neonatal VAP is high in Yancheng Maternal and Child Health Hospital of Jiangsu Province from January 2018 to October 2021, and the pathogenic bacteria are mainly Gram-negative bacteria. The occurrence of neonatal VAP is related to a variety of factors, and the clinical measures should be taken according to the relevant influencing factors.