Early Predictors of Ventilator Associated Pneumonia in Preterm Neonates Admitted in a Special Newborn Care Unit

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 a...

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Published in:Indian pediatrics 2024-01, Vol.61 (1), p.45-48
Main Authors: Pahwa, Simran, Sethi, Amanpreet, Kaur, Gurmeet, Dhir, Shashi Kant, Jindal, Neerja, Rai, Seema, Jindal, Sakshi
Format: Article
Language:English
Subjects:
Female
Gestational Age
Hospitalization
Humans
Infant
Infant, Newborn
Maternal and Child Health
Medicine
Medicine & Public Health
Original Article
Parturition
Pediatric Surgery
Pediatrics
Pneumonia, Ventilator-Associated - diagnosis
Pneumonia, Ventilator-Associated - epidemiology
Pregnancy
Respiration, Artificial - adverse effects
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Summary: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.
ISSN:0019-6061
0974-7559
DOI:10.1007/s13312-024-3086-3