title: [Risk factors for ventilator-associated pneumonia in neonates and the changes of isolated pathogens].
abstract: OBJECTIVE
  To study the risk factors for neonatal ventilator-associated pneumonia (VAP) and the changes of isolated pathogens in the last eight years.
  
  
  METHODS
  The clinical data of 230 neonates who were admitted into the neonatal intensive care unit (NICU) and received mechanical ventilation for equal to or longer than 48 hrs in 2008 were retrospectively reviewed. The isolated pathogens were compared with those of eight years ago.
  
  
  RESULTS
  The incidence of VAP (25.2%) in the year 2008 was lower than that of eight years ago (36.1%; P<0.05). The development of VAP was negatively correlated with the gestational age and the birth weight, but positively correlated with the duration of mechanical ventilation, intubation times, duration of hospitalization, presence of gastrointestinal bleeding and need for blood products transfusion. The main isolated pathogens were opportunistic antibiotics resistant bacteria, and the majority was gram negative bacilli (77%). The most frequently detected gram negative bacilli were Klebsiella (20%), Stenotrophomonas maltophilia (18%) and Acinetobacter (13%). Streptococcus mitis was the most frequently detected gram positive bacilli (14%). The distribution pattern of pathogens isolated in the same NICU eight years ago was somewhat different: Klebsiella (23%), Pseudomonas aeruginosa (17%), Acinetobacter (16%), Streptococcus mitis (11%), Fungi (1%) and Candida albicans (1%).
  
  
  CONCLUSIONS
  The incidence of VAP is correlated with gestational age, birth weight, duration of mechanical ventilation and hospitalization, intubation times, presence of gastrointestinal bleeding and need for blood products transfusion. The main isolated pathogens are usually antibiotic resistant opportunistic bacteria. The detection rate of Stenotrophomonas maltophilia increased and that of Pseudomonas aeruginosa decreased when compared with eight years ago.
authors.affiliation: Department of Neonatology, Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China. Email: csq5725@yahoo.com.cn.
authors.forename: Yan-Fen
authors.initials: YF
authors.lastname: Ying
authors.forename: Shang-Qin
authors.initials: SQ
authors.lastname: Chen
authors.forename: Xiao-Ya
authors.initials: XY
authors.lastname: Hu
authors.forename: Neng-Li
authors.initials: NL
authors.lastname: Wang
authors.forename: Hua-Lan
authors.initials: HL
authors.lastname: Liu
authors.forename: Shu-Ying
authors.initials: SY
authors.lastname: Hu
authors.forename: Zhen-Lang
authors.initials: ZL
authors.lastname: Lin
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D053717:Pneumonia, Ventilator-Associated; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents