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

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Abstract

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.

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References

  1. Miller JD, Carlo WA. Pulmonary complications of mechanical ventilation in neonates. Clin Perinatal. 2008;35:273–81.

    Article  Google Scholar 

  2. Garland JS. Ventilator-Associated Pneumonia in Neonates: An Update. Neo Reviews. 2014;15:e225–35.

    Google Scholar 

  3. Foglia E, Meier MD, Elward A. Ventilator-associated pneumonia in neonatal and pediatric intensive care unit patients. Clin Microbiol Rev. 2007;20:409–25.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Goerens A, Lehnick D, Büttcher M, et al. Neonatal ventilator associated pneumonia: A quality improvement initiative focusing on antimicrobial stewardship. Front Pediatr. 2018;6:262.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Tripathi S, Malik GK, Jain A, Kohli N. Study of ventilator associated pneumonia in neonatal intensive care unit: characteristics, risk factors and outcome. Internet Journal of Medical Update. EJOURNAL 2010;5:12–9.

    Article  Google Scholar 

  6. Gupta MK, Mondkar J, Swami A, et al. Endotracheal aspirate microscopy, cultures and endotracheal tube tip cultures for early prediction of ventilator associated pneumonia in neonates. Indian Pediatr. 2017;54:211–4.

    Article  PubMed  Google Scholar 

  7. Cernada M, Brugada M, Golombek S, Vento M. Ventilator-associated pneumonia in neonatal patients: An update. Neonatology. 2014;105:98–107.

    Article  PubMed  Google Scholar 

  8. Lee PL, Lee WT, Chen HL. Ventilator-associated pneumonia in low birth weight neonates at a neonatal intensive care unit: a retrospective observational study. Pediatr Neonatol. 2017;58:16–21.

    Article  PubMed  Google Scholar 

  9. Petdachai W. Ventilator-associated pneumonia in a newborn intensive care unit. Southeast Asian J Trop Med Public Health. 2004;35:724–9.

    PubMed  Google Scholar 

  10. Badr MA, Ali YF, Albanna EA, et al. Ventilator associated pneumonia in critically-ill neonates admitted to neonatal intensive care unit, Zagazig university hospitals. Iran J Pediatr. 2011;21:418–24.

    PubMed  PubMed Central  Google Scholar 

  11. Rai R, Sethi A, Kaur A, et al. Quality Improvement Initiative to Improve Hand Hygiene Compliance in Indian Special Newborn Care Unit. Pediatr Qual Saf. 2021;6:e492.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Khattab AA, El-Lahony DM, Soliman WF. Ventilator-associated pneumonia in the neonatal intensive care unit. Menoufia Med J. 2014;27:73–7.

    Article  Google Scholar 

  13. Afjeh SA, Sabzehei MK, Karimi A, et al. Surveillance of ventilator-associated pneumonia in a neonatal intensive care unit: characteristics, risk factors, and outcome. Arch Iran Med. 2012;15:567–71.

    PubMed  Google Scholar 

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Funding

Funding: None

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Authors and Affiliations

  1. Department of Pediatrics (Neonatology), Guru Gobind Singh Medical College, Faridkot, Punjab, 151 203, India

    Simran Pahwa,  Amanpreet Sethi, Gurmeet Kaur, Shashi Kant Dhir, Seema Rai & Sakshi Jindal

  2. Department of Microbiology, Guru Gobind Singh Medical College, Faridkot, Punjab, India

    Neerja Jindal

Authors
  1. Simran Pahwa
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  2. Amanpreet Sethi
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  3. Gurmeet Kaur
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  4. Shashi Kant Dhir
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  5. Neerja Jindal
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  6. Seema Rai
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  7. Sakshi Jindal
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Contributions

Contributors: SP: Conceptualized and designed the study, analyzed data and drafted the manuscript; AS: Conceptualized and designed the study, supervised data collection and drafted the manuscript; GK: Conceptualized and designed the study and supervised the sample collection and manuscript; SKD: Supervised data and samples collection and provided inputs for writing the manuscript; NJ: Supervised sample collection and analysis of samples in the microbiology department; SR: assisted in sample collection, data analysis, and writing of manuscript; SJ: Assisted in sample collection, data analysis, and writing of manuscript. All authors approved the final version of manuscript, and are accountable for all aspects related to the study.

Corresponding author

Correspondence to Amanpreet Sethi.

Ethics declarations

Ethics clearance: Institutional ethics committee, Guru Gobind Singh Medical College, Faridkot, Punjab; No. BFUHS/2K19p-TH/893 dated May 29, 2019.

Competing interests: None stated.

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Pahwa, S., Sethi, A., Kaur, G. et al. Early Predictors of Ventilator Associated Pneumonia in Preterm Neonates Admitted in a Special Newborn Care Unit. Indian Pediatr 61, 45–48 (2024). https://doi.org/10.1007/s13312-024-3086-3

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  • DOI: https://doi.org/10.1007/s13312-024-3086-3

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