新生儿呼吸机相关性肺炎的高危因素Logistic回归分析

Logistic regression analysis in high risk factors of neonatal ventilator-associated pneumonia

目的探讨新生儿呼吸机相关性肺炎(NVAP)的影响因素、病原菌分布及耐药情况。方法选择行机械通气(MV)的250例患儿,按是否并发NVAP分为VAP组和非VAP组。回顾性分析NVAP的相关影响因素、病原菌特点、耐药情况。结果本组250例患儿VAP的发生率为58.4%。多因素Logistic回归分析显示,呼吸机使用时间及原发感染性疾病与VAP的发生呈正相关,而胎龄及肠道益生菌的使用与VAP的发生呈负相关。病原菌分布以革兰阴性菌为主,其中前3位分别为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯杆菌。结论危重新生儿的VAP发生率较高,其发生与多种因素密切相关。VAP主要致病菌为革兰阴性菌,且耐药率较高。

Objective To investigate the risk factors,pathogenic bacteria distribution and drug sensitivity of neonatal ventilator-associated pneumonia（ NVAP）. Methods A total of 250 children with mechanical ventilation（ MV） were selected and divided into VAP group and non-VAP group according to condition of NVAP. The independent risk factors,pathogenic bacteria distribution and drug sensitivity were retrospectively analyzed. Results The incidence rate of VAP was 58. 4%in 250 children. Multi-factor Logistic regression analysis showed that the duration of mechanical ventilation and primary infectious disease were positively correlated with VAP,and the gestational age and use of probiotics were negatively correlated with VAP. The pathogens were mainly gram-negative bacteria,among which the first three pathogens were bauman acinetobacter,pseudomonas aeruginosa and klebsiella pneumoniae. Conclusion The incidence rate of VAP is high in critical neonates. Incidence of VAP is associated with many factors. The main pathogen for VAP is gram-negative bacteria,and its multi-drug resistance is severe.