目的：随着现代儿科急救医学和新生儿医学的发展, 新生儿呼吸机相关性肺炎(VAP)作为NICU内主要的医院获得性感染已日益受到重视。由于VAP发病机制的复杂性，目前国内关于VAP的高危因素研究较少。该研究旨在初步探讨VAP的发病率﹑病原学和高危因素, 为VAP的防治提供一定的理论依据。方法：回顾分析2003～2005年南昌大学第一附属医院NICU呼吸机治疗的106例危重新生儿的临床资料。结果：VAP发病率为41.7％,单因素分析发现早产儿、低体重、机械通气时间、原发肺部疾患、再插管、有无大剂量使用丙种球蛋白等因素与VAP有关(P＜0.05）。Logistic回归确定机械通气时间、原发肺部疾患、再插管、有无大剂量使用丙种球蛋白为VAP影响因素(P＜0.05）。病原菌主要是耐药性条件致病菌，以革兰阴性杆菌为主(76.9％)。结论：致病菌主要是耐药性条件致病菌；VAP的高危因素众多，其发病机制复杂，是外部环境与患者内环境因素综合作用的结果,采取综合防治措施可能是控制VAP的最佳策略。［中国当代儿科杂志，2007，9（6）：549-552］

OBJECTIVE: Ventilator-associated pneumonia (VAP) is a common nosocomial infection and is responsible for a very high mortality in neonatal intensive care unit (NICU) patients. This study was designed to investigate the etiology and high risk factors of neonatal VAP. METHODS: The clinical data of 106 critical neonates who were treated with mechanical ventilator between 2003 and 2005 were studied retrospectively. ResultsOf the 106 neonates, 84 received mechanical ventilation for ≥ 48 hrs. Thirty-five (41.7%) out of the 84 patients developed VAP. Univariate analysis showed that gestational age, duration of mechanical ventilation, reintubation, birth weights, primary lung disease and gamma globulin administration were associated with the development of VAP (P<0.05). Multivariate stepwise logistic regression analysis showed that primary lung disease (OR=3.671, 95% CI=1.0-13.45, P<0.05), duration of mechanical ventilation (OR=4.945, CI=1.51-16.21, P<0.01), reintubation (OR=7.721, 95% CI=2.31-25.85, P<0.01) and high-dose gamma globulin administration (OR=5.520, 95%CI=2.08-16.26, P<0.01) were predicted factors for the development of VAP. The detection rate of gram negative bacilli (76.9%) was the highest, followed by gram positive coccus (17.9%) in VAP patients. CONCLUSIONS: Opportunistic drug-resistant bacteria are common pathogens for neonatal VAP. The risk of VAP is multifactorial, including external medical environments and patients' internal agents.［Chin J Contemp Pediatr, 2007, 9 (6):549-552］