Pneumonia in newborns

Abstract

Depending on the time and conditions of infection, neonatal pneumonia is divided into intrauterine and postnatal, which can be community-acquired, nosocomial, ventilator-associated, aspiration. Congenital pneumonia, which is difficult to distinguish from the respiratory distress syndrome of newborns is a component of generalized infection of the fetus and newborn. According to the time of clinical manifestations, neonatal pneumonia is divided into early (the first week of life) and late (828 days of life). The etiology of pneumonia in newborns depends on the time, path and conditions of infection. The diagnosis of pneumonia in newborns is determined by the level and equipment of the clinic and is based on the determination of antenatal and postnatal risk factors, respiratory and general symptoms, radiological signs, markers of the systemic inflammatory reaction/bacterial infection syndrome and the results of etiological diagnosis. The deterioration of the newborn's condition on a ventilator can be associated not only with ventilator-associated, but also with other fan-associated events (fan-associated condition; ventilator is an associated event in children receiving antimicrobials), the causes of which may be pulmonary edema, atelectasis, acute respiratory distress syndrome, recent surgical procedures, sepsis, the formation of bronchopulmonary dysplasia. For the initial therapy of early neonatal pneumonia, a combination of ampicillin with gentamicin is used. In case of late neonatal pneumonia that occurred in a hospital, primary therapy should necessarily include anti-pseudomonas and anti-staphylococcal antibiotics. For community-acquired pneumonia in newborns, antibiotics acting on gram-negative bacteria (inhibitor-protected beta-lactams, cephalosporins of the third generation, aminoglycosides) are prescribed.