摘要
目的分析新生儿病房院内感染发生的临床特征,为预防和控制院内感染提供依据。方法回顾性调查2016年1月—2017年12月在钦州市妇幼保健院新生儿科住院的5316例患儿,分析发生院内感染的64例患儿的临床特点。结果新生儿病房院内感染发生率为1.20%(64/5316),前三位易发生感染的部位/病种分别为:呼吸系统/肺炎(64.06%)、眼部/细菌性结膜炎(14.06%)、血液系统/败血症(12.50%),病原菌以肺炎克雷伯菌为主。出生体重<1500g、出生胎龄<32周的早产儿院内感染的发生率显著高于出生体重≥1500g(11.83%vs 0.65%)、出生胎龄≥32周(12.73%vs 0.58%)的新生儿(P <0.001)。住院日>30d的患儿院内感染发生率明显高于住院日≤30d的患儿(26.14%vs 0.35%,P <0.001)。机械通气(OR=4.616,95%CI:2.785～7.651)、留置外周中心静脉置管(PICC)(OR=31.387,95%CI:18.580～53.021)、特殊使用级抗生素使用(OR=4.388,95%CI:2.648～7.271)是新生儿院内感染发生的危险因素。结论我院新生儿病房院内感染部位以呼吸系统为主,病原菌以肺炎克雷伯菌为主。机械通气、留置PICC、特殊使用级抗生素应用是新生儿院内感染发生的危险因素。出生体重<1500g、出生胎龄<32周、住院日>30d的患儿院内感染的发生率高,是院内感染重点防范的人群。
Objective To investigate clinical characteristics of nosocomial infection in neonatal wards so as to provide basis for the prevention and control of nosocomial infection.Methods A retrospective investigation was conducted on 5316 children hospitalized in the Neonatology Department of Meternal and Child Health Care Hospital of Qinzhou City from January 2016 to December 2017,and the clinical characteristics of 64 children with nosocomial infection were analyzed.Results The incidence of nosocomial infection in neonatal wards was 1.20%(64/5316),and the top three easily infected sites/disease kinds were pneumonia (64.06%),bacterial conjunctivitis (14.06%) and sepsis (12.50%),and Klebsiella pneumoniae was the main pathogen.The incidence of nosocomial infection in premature infants with birth weight <1500 g and gestational age <32 weeks was significantly higher than those with birth weight ≥1500 g (11.83% vs 0.65%) and gestational age ≥32 weeks (12.73% vs 0.58%)(P<0.001).The incidence of nosocomial infection in diseased infants with >30 days of hospitalization was significantly higher than those with ≤30 days of hospitalization (26.14% vs 0.35%,P<0.001).Mechanical ventilation( OR =4.616,95% CI :2.785~7.651),indwelling peripherally inserted central catheter(PICC)( OR =31.387,95% CI :18.580~53.021),use of special-use-grade antibiotic( OR =4.388,95% CI :2.648~7.271) were the risk factors of nosocomial infection.Conclusion The most common infected site of nosocomial infection in the neonatal ward of our hospital was respiratory system and Klebsiella pneumoniae was the main pathogen.Mechanical ventilation,PICC,use of special-use-grade antibiotic were the risk factors for nosocomial infection.The premature infants with birth weight <1500 g,gestational age <32 weeks and hospitalization>30 days have higher incidences of nosocomial infection and they were the key population for prevention of nosocomial infection.
作者
陆岸锋
黄海燕
黄国盛
毕雷
施永秀
Lu Anfeng;Huang Haiyan;Huang Guosheng;Bi Lei;Shi Yongxiu(Department of Neonatology,Meternal and Child Health Care Hospital of Qinzhou City,Qinzhou 535099,Guangxi,China)
出处
《右江民族医学院学报》
2019年第2期168-172,共5页
Journal of Youjiang Medical University for Nationalities
关键词
婴儿
新生
医院内感染
发病率
病原菌
infant,newborn
nosocomial infection
incidence
pathogens
