The etiology of neonatal pneumonia, complicated by bronchopulmonary dysplasia.

Autor: Kushnareva MV; Academician Yu. E. Veltishchev Research Clinical Institute of Pediatrics, N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, Moscow; Russian Federation., Keshishyan ES; Academician Yu. E. Veltishchev Research Clinical Institute of Pediatrics, N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, Moscow; Russian Federation., Balashova ED; The City Clinical Hospital number 13, Moscow, Russian Federation.
Jazyk: angličtina
Zdroj: Journal of neonatal-perinatal medicine [J Neonatal Perinatal Med] 2019; Vol. 12 (4), pp. 429-436.
DOI: 10.3233/NPM-17159
Abstrakt: Background: The frequency of bronchopulmonary dysplasia (BPD) in preterm infants with a "ventilator-associated" pneumonia (VAP) ranges between 7 to 50%.
Objective: To investigate the features of the etiological structure of neonatal pneumonia complicated by BPD, and to determine the sensitivity of pathogens to antibiotics.
Methods: A retrospective chart review of 194 preterm infants with VAP, birth weight from 780 to 2820 g and gestational age from 27 to 37 weeks was conducted. A microbiological study of washings from the respiratory tract was conducted by standard qualitative and quantitative methods.
Results: Respiratory tract infections caused by E. coli (with hemolytic properties), Enterococcus spp. (with hemolytic properties), Pseudomonas aeruginosa, Stenotrophomonas maltophilia, various types of mycoplasmas, Staphylococcus aureus, and Candida krusei were found 4- 13 times more frequent in preterm infants with BPD than in preterm infants without BPD and more mature infants with or without this complication. BPD developed 7- 11 times more frequent in preterm infants with prolonged VAP and change in pathogens than in preterm infants with VAP without change of agent. BPD developed 5- 7 times more frequent in preterm infants with the association of pathogens than in preterm infants with a monoinfection. Massive colonization of respiratory tract pathogens by 1- 3 days of life (lg4 colony forming units in 1 ml and above) was an unfavorable prognostic factor for the development of VAP, complicated by BPD.
Conclusion: The reduction in the frequency of BPD is might be possible with timeous and adequate antibacterial therapy of VAP.
Databáze: MEDLINE
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