Ventilator-associated pneumonia in premature newborns admitted to the intensive care unit

Objective: To explore the clinical features and prevention measures of ventilator associated pneumonia (VAP) of premature newborns treated with mechanical ventilation (MV). Methods: From June 2010 to June 2017, a retrospective analysis of 200 premature newborns, including 56 critically ill premature newborns with VAP who received MV treatment and 144 premature newborns who received MV treatment but no VAP occurring served as the control. Of the 56 infants, 20 and 36 were treated with and without antibiotic, and the two groups were labeled as the VAP+Ab group and the VAP group, respectively. The gestational age, birth weight, Apgar score and primary disease of the premature were recorded. Additionally, the survival rates, MV days, APACHE II scores, and the hospital stays were compared. Results: The three groups exhibited no significant differences in the gestational ages, birth weights, Apgar scores. The premature newborns without VAP occurring (the control) had a survival rate of approximately 90%, much higher than the VAP group (60%) (P=0.045). Prophylactic use of antibiotics could significantly improve (P=0.032), with the survival rate of the premature newborns with VAP reaching nearly 85%. Compared with the VAP group, the control group exhibited a shorter MV day (P<0.001), hospital stay (P<0.001), and lower APACHEII score (P=0.025). However, prophylactic use of antibiotics significantly shortened the MV day (P=0.001), hospital stays of the VAP-associated premature newborns (P<0.001), and also lowered their APACHE II scores (P=0.034), suggesting the prophylactic use of antibiotics may be a potential way to improve the health status of the infants. Conclusion: As compared to their counterparts without VAP, the premature infants associated with VAP had lower survival rates, longer MV days, and hospital stays. The prophylactic use of antibiotics, however, can significantly improve the survival rate of premature infants associated with VAP, lower their MV days and hospital stays, and improve their health status.