title: Risk factors for ventilator-associated pneumonia in neonatal intensive care unit patients.
abstract: Ventilator-associated pneumonia (VAP) is a serious complication in neonatal patients on mechanical ventilation. The objective of this study was to examine the incidence and risk factors associated with VAP, particularly in every 7-day versus every 14-day ventilator circuit changes, in a neonatal intensive care unit (NICU). Seventy-one neonates hospitalized in the NICU were enrolled. First, the neonates were divided into groups with and without VAP. On univariate logistic regression analyses, prolonged mechanical ventilation, frequent re-intubation, low gestational age, and low birth weight (BW) were significant risk factors for VAP development. After adjustments for other variables, only BW <626 g was a significant independent predictor for VAP in NICU infants. Second, to examine the effect of the frequency of changing ventilator circuits on the incidence of VAP, circuit changes were compared between the every 7-day group and the every 14-day group. The incidence of VAP per 1000 ventilator days was 9.66 for the every 7-day group and 8.08 for the every 14-day group, and there was no significant difference between the 2 groups. BW <626 g was a significant independent predictor of VAP, and decreasing the frequency of ventilator circuit changes from every 7 days to 14 days had no adverse effect on the VAP rate in the NICU.
authors.affiliation: Infection Control Team, Osaka Medical College Hospital, Japan.
authors.forename: Fumiko
authors.initials: F
authors.lastname: Kawanishi
authors.affiliation: Department of Nursing, Osaka Medical College Hospital, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Yoshinaga
authors.affiliation: Infection Control Team, Osaka Medical College Hospital, Japan.
authors.forename: Michiyo
authors.initials: M
authors.lastname: Morita
authors.affiliation: Department of Nursing, Osaka Medical College Hospital, Japan; Department of Clinical Laboratory, Osaka Medical College Hospital, Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Shibata
authors.affiliation: Infection Control Team, Osaka Medical College Hospital, Japan; Department of Pharmachology, Osaka Medical College Hospital, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Infection Control Team, Osaka Medical College Hospital, Japan; Department of General Internal Medicine, Osaka Medical College, Japan.
authors.forename: Yukimasa
authors.initials: Y
authors.lastname: Ooi
authors.affiliation: Infection Control Team, Osaka Medical College Hospital, Japan; Department of General Internal Medicine, Osaka Medical College, Japan. Electronic address: in3011@poh.osaka-med.ac.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Ukimura
mesh_terms: D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D008297:Male; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology*; D012121:Respiration, Artificial / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: Neonatal intensive care unit (NICU); Ventilator circuit; Ventilator-associated pneumonia (VAP)