Ventilator-Associated Pneumonia Caused by Klebsiella Pneumoniae in Preterm Newborn Infants

Abstract

Background: The basis for the study is the high morbidity and mortality in premature infants with ventilator-associated pneumonia (VAP). There is a high incidence of complications (sepsis, bronchopulmonary dysplasia). Methods: A detailed analysis of the clinical course of VAP caused by Klebsiella pneumoniae in 14 premature infants was conducted. The sensitivity of Klebsiella pneumoniae strains to 18 antibiotics was studied by the method of standard discs. Results: Severe pneumonia had 10 infants, moderate stage was among 4 infants, an acute stage was observed in 12 patients, and prolonged stage was in 2 infants. Severe form of the disease was presented by pronounced symptoms of infectious toxicosis, respiratory and cardiovascular insufficiency, physical changes from the lungs. Bronchopulmonary dysplasia was developed in two infants. The mortality was rated 14%. Klebsiella pneumoniae was the causative agent of the primary infection in all infants (monoinfection was in 12 infants and association with other pathogens in 2 infants). All strains of Klebsiella pneumoniae were multidrug-resistant to antibiotics, but 57-86% of the strains retained sensitivity to Piperacillin, Piperacillin + Tazobactam, carbapenems, Amikacin and Ofloxacin. Conclusions: The complex treatment of VAP in premature infants should include antibacterial, detoxification, pathogenetic and syndromic therapies.