Background
Ventilator-associated pneumonia (VAP) is defined by the
Center for Disease Control and Prevention (CDC) and
National Healthcare Safety Network as new and persistent
radiographic infiltrates and worsening gas exchange
in infants who are ventilated for at least 48 h and who
exhibit least 3 of the following criteria: temperature instability
with no other recognized cause, leukopenia,
change in the characteristic of respiratory secretions, respiratory
distress and bradycardia or tachycardia [1].
VAP is a serious complication in neonates on mechanical
ventilation and account for 6.8 - 32.2 % of health-care associated
infections among neonates [2, 3]. It has a large
impact on neonatal morbidity, survival, hospital costs
and duration of neonatal intensive care unit (NICU)
stay [3, 4]. The effect of VAP on health care costs is especially
significant in developing world, whereas most
studies of VAP have been conducted in developed
countries [5, 6].