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The etiology of neonatal pneumonia, complicated by bronchopulmonary dysplasia

M V Kushnareva1, E S Keshishyan1, E D Balashova2

  • 1Academician 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.

Journal of Neonatal-Perinatal Medicine
|August 6, 2019
PubMed

Insights

Bronchopulmonary dysplasia (BPD) is more common in preterm infants with ventilator-associated pneumonia (VAP). Timely antibiotic treatment of VAP may reduce BPD incidence.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Infectious Diseases

Background:

  • Bronchopulmonary dysplasia (BPD) affects 7-50% of preterm infants with ventilator-associated pneumonia (VAP).
  • Understanding the etiological factors of VAP-complicated BPD is crucial for prevention and treatment.

Purpose of the Study:

  • To investigate the etiological structure of neonatal pneumonia in preterm infants complicated by BPD.
  • To determine the antibiotic sensitivity of identified pathogens.

Main Methods:

  • Retrospective chart review of 194 preterm infants diagnosed with VAP.
  • Microbiological analysis of respiratory tract washings using standard qualitative and quantitative methods.

Main Results:

  • Specific pathogens (E. coli, Enterococcus spp., P. aeruginosa, S. maltophilia, Mycoplasma, S. aureus, C. krusei) were 4-13 times more frequent in preterm infants with BPD.
  • Prolonged VAP with pathogen shifts increased BPD development 7-11 times; polymicrobial infections increased it 5-7 times.
  • Early massive respiratory pathogen colonization (1-3 days) was an unfavorable prognostic factor for VAP complicated by BPD.

Conclusions:

  • Timely and adequate antibacterial therapy for VAP may reduce the incidence of BPD in preterm infants.
  • Identifying specific pathogens and their antibiotic sensitivities is key to effective VAP management and BPD prevention.
Abstract

Keywords:
Preterm infantsantibioticsbronchopulmonary dysplasiamicroorganismspneumonia

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