title: Device-associated pneumonia of very low birth weight infants in Polish Neonatal Intensive Care Units.
abstract: OBJECTIVE
  Late-Onset Pneumonia (LO-PNEU) is still the most important complication associated with the hospitalization of infants with very low birth weight (<1501g). The purpose of this paper is to summarize the results of an ongoing surveillance program defining LO-PNEU as associated or not associated with respiratory support in the NICU and distribution of causative pathogens from the Polish Neonatology Surveillance Network (PNSN).
  
  
  METHODS
  Surveillance of infections was conducted in the years 2009-2011 at six Polish NICUs.
  
  
  RESULTS
  The incidence was 3.1/1000 NICU patient days (pds). The mean gestational age and birth weight among infants with LO-PNEU were significantly lower. The VAP incidence was of 18.2/1000 NICU pds for mechanically ventilated (MV) infants, while the rates for those receiving only CPAP were as low as 7.7/1000 NICU pds. MV significantly increased the risk of PNEU, but MV or CPAP for <10 days did not increase the risk of LO-PNEU. Significantly associated with LO-PNEU was the use of central or peripheral venous catheters and total parenteral nutrition for longer periods. Microorganisms isolated in cases of LO-PNEU were Gram-positive cocci (53.5%) and Gram-negative rods, with predominating E. coli. Non fermentative bacilli were significantly more frequent in cases of VAP than in other cases.
  
  
  CONCLUSIONS
  Observed incidence rates associated with VAP and CPAP-PNEU, were higher than in other national surveillance systems and expressing the feasibility of lowering the risk of LO-PNEU and increasing patient safety. The incidence of pneumonia was found to be lower when using CPAP as compared to using MV.
authors.affiliation: Chair of Microbiology, Jagiellonian University Medical College, Krakow, Poland. Electronic address: mbmach@cyf-kr.edu.pl.
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Wójkowska-Mach
authors.affiliation: Division of Neonatology, Loma Linda University Children's Hospital, Loma Linda, CA, USA.
authors.forename: T Allen
authors.initials: TA
authors.lastname: Merritt
authors.affiliation: Clinic of Neonatology and Intensive Neonatal Care, Warsaw Medical University, Warsaw, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Borszewska-Kornacka
authors.affiliation: Institute of Theoretical and Applied Informatics of Polish Academy of Sciences, Gliwice, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Domańska
authors.affiliation: Clinic of Neonatology, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Gulczyńska
authors.affiliation: Clinic of Neonatology, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Nowiczewski
authors.affiliation: Clinic of Neonatology and Intensive Neonatal Care, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Helwich
authors.affiliation: Department of Neonatal Diseases, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Kordek
authors.affiliation: Clinic of Neonatology, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Pawlik
authors.affiliation: Institute of Nature Conservation, Polish Academy of Sciences, Krakow, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Adamski
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D008297:Male; D053717:Pneumonia, Ventilator-Associated / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D011044:Poland / Q000453:epidemiology; D012137:Respiratory System / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Device-associated pneumonia; Non fermentative bacilli; Pneumonia; Surveillance; Very low birth weight newborns