title: Ventilator-Associated Pneumonia in Low Birth Weight Neonates at a Neonatal Intensive Care Unit: A Retrospective Observational Study.
abstract: Ventilator-associated pneumonia (VAP) is one of the most common healthcare-associated infections among ventilated patients. The aim of this study was to determine the clinical characteristics and risk factors for the development of VAP in intubated low birth weight (LBW) neonates in a neonatal intensive care unit.
  
  
  
  LBW infants (<2.5 kg) admitted to the neonatal intensive care unit of Kaohsiung Medical University Hospital from January 2005 to December 2009 were enrolled. We retrospectively analyzed perinatal and neonatal data of the enrolled intubated LBW infants by chart review.
  
  
  
  Six hundred and five LBW infants were analyzed. One hundred and fourteen of the infants were intubated for >48 hours, 15 (13.2%) of whom had VAP. Of these 15 patients, the average age at onset of VAP was 24.0 ± 11.2 days, the average postmenstrual age was 30.6 ± 1.8 weeks, and the mean gestational age was 27.1 ± 2.3 weeks, which was significantly lower than the mean gestational age in the group without VAP (30.2 ± 3.5 weeks). The mean birth body weight was 944.4 ± 268.4 g in the VAP group and 1340.1 ± 455.4 g in the group without VAP (p < 0.001). Longer duration of intubation (odds ratio: 1.35, 95% confidence interval: 1.12-1.62) and parenteral nutrition (odds ratio: 1.32, 95% confidence interval: 1.14-1.51) were found in the VAP group after adjusting for gestational age and birth weight.
  
  
  
  VAP was a problem for the LBW infants with intubation for >48 hours in our neonatal intensive care unit. VAP most frequently occurred at a postmenstrual age of 30-32 weeks in this study. Longer duration of tube placement and parenteral nutrition were found in the VAP group. Early removal of the endotracheal tube and adequate enteral nutrition may decrease the occurrence of VAP in LBW infants.
authors.affiliation: Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Pei-Lun
authors.initials: PL
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Wei-Te
authors.initials: WT
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: 840062@ms.kmuh.org.tw.
authors.forename: Hsiu-Lin
authors.initials: HL
authors.lastname: Chen
mesh_terms: D001724:Birth Weight; D004750:Enteral Nutrition; D005260:Female; D005865:Gestational Age; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007442:Intubation, Intratracheal; D008297:Male; D016017:Odds Ratio; D053717:Pneumonia, Ventilator-Associated / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: intubation; low birth weight infant; neonatal intensive care unit; preterm; ventilator associated pneumonia