[Pulmonary infections in preterm newborns].
OBJECTIVE
The aim of this study was to evaluate retrospectively the incidence and etiology of connatal pneumonia and ventilator-associated pneumonia (VAP) in preterm newborns who had birth weight = or < 1250 g and required intubation for at least 12 h.


METHODS
We have reported data about preterm newborns who had birth weight = or < 1250 g and required intubation for at least 12 h with diagnosis of connatal pneumonia and VAP, admitted to the neonatal intensive care unit from 1994 to 2004. We divided these 11 years into 4 periods. For each period we determined etiology associated with connatal pneumonia or VAP.


RESULTS
A total of 417 patients were studied; 311 (74.6%) required mechanical ventilation (MV) for more than 48 h (the least for the diagnosis of VAP). Connatal pneumonia occurred in 35/417 patients (8.4%). VAP incidence did not change over time showing a slight increase in the last 2 years (from 27% to 33%). Mycoplasma and Chlamydia as causative organisms of connatal pneumonia dissapear during years. Gram-negative micro-organisms were isolated more frequently in last years in VAP episodes.


CONCLUSIONS
The incidence of VAP does not decrease over time although length of MV was reduced. Additional studies are needed to improve criteria for the diagnosis and prevention of VAP in NICU patients.
Vendettuoli
V
V
Divisione di Neonatologia, Istituto di Clinica Pediatrica Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Roma.
De Cunto
A
A
Tana
M
M
Tirone
C
C
Boccacci
S
S
Vento
G
G
Romagnoli
C
C
D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000382:microbiology*; D019102:Infant, Very Low Birth Weight; D018410:Pneumonia, Bacterial / Q000453:epidemiology*; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology*; D012189:Retrospective Studies