Microbiological monitoring of continuous positive airway pressure and resuscitation equipment in very-low birth weight infants

Pediatr Res. 2018 Jan;83(1-1):78-82. doi: 10.1038/pr.2017.223. Epub 2017 Oct 11.

Abstract

BackgroundTo investigate the colonization of respiratory equipment and the rate of respiratory infections of very-low birth weight (VLBW) infants.MethodsThe prospective study includes 26 VLBW infants on continuous airway pressure (CPAP) from September until December 2012. Swabs from respiratory equipment and colonization/infections were evaluated.ResultsA total of 603 swabs was cultured with 298 isolates; 59% of cultures from CPAP equipment (n=337; 95% confidence interval (CI; 54;64)) and 19% from ambu bags (n=51; 95% CI (14;24)) were positive. Overall, 181/201 CPAP prongs and masks hosted 221 microorganisms. Colonization on days 3 and 7 were 93% and 87%, respectively, with an increase in pathogens and a decrease in skin flora (79% vs. 68%). Comparing the 58 paired swab results from days 3 and 7 showed an increase in Gram-negative bacteria (P=0.014). Eighteen infants had positive weekly screening results, with similar colonization of CPAP equipment, dominated by Enterobacteriacae. Pneumonia was diagnosed in two infants.ConclusionOf the CPAP equipment close to the patient, 90% was colonized with microorganisms increasing during 1 week of CPAP. The pathogens were dominated by gastrointestinal bacteria, and persisted over weeks. Frequent cleaning did not prevent pneumonia, although pneumonia rates were rare.

MeSH terms

  • Bacteremia / etiology
  • Colony Count, Microbial
  • Continuous Positive Airway Pressure / adverse effects*
  • Equipment Contamination*
  • Female
  • Gram-Negative Bacteria
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Very Low Birth Weight
  • Intensive Care, Neonatal
  • Male
  • Pneumonia / microbiology
  • Prospective Studies
  • Resuscitation / adverse effects*