Predictors of Ventilator Associated Pneumonia in Preterm Neonates Admitted in a Special Newborn Care Unit

A new study aimed to assess the usefulness of microscopic examination and culture of endotracheal aspirate (ETA) in the early diagnosis of ventilator-associated pneumonia (VAP) in preterm neonates.

This prospective, observational study included 80 neonates with a gestational age below 37 weeks, requiring mechanical ventilation for at least 48 hours in a Special Newborn Care Unit (SNCU). VAP diagnosis followed the Centers for Disease Control (CDC) criteria.

Out of the neonates enrolled, 58.5% developed VAP––resulting in an overall incidence of 74.7/1000 ventilator-days. ETA culture demonstrated a shorter time to diagnosis compared to CDC criteria, with a sensitivity of 80.8% and specificity of 72.7%. Outborn delivery emerged as the primary risk factor for VAP, and multidrug-resistant Klebsiella pneumoniae was the predominant organism.

From the findings, it was inferred that in their high VAP incidence unit, ETA culture and microscopy provided an early diagnostic opportunity compared to CDC clinical criteria, emphasizing the effectiveness of these methods in identifying VAP in ventilated preterm neonates.

Source: Pahwa S, Sethi A, Kaur G, Dhir SK, Jindal N, Rai S, Jindal S. Indian Pediatrics. 2024 Jan;61(1):45-8.