摘要
目的 探讨新生儿重症监护室 (NICU)医院感染的特点及预防措施。方法 回顾分析近 4年来 31 33例住院新生儿医院感染发生情况。结果 发生医院感染 2 74例 ,总的医院感染率为 8 7% ,感染部位以呼吸道为主 ,占医院感染的 5 0 7% ,其中呼吸机相关性肺炎占 2 0 8%。医院感染患儿中 1 0 5例病原菌培养阳性 ,共检出 1 31株病菌 ,革兰阴性杆菌 1 0 9株 (83 2 % ) ,革兰阳性球菌 2 2株 (1 6 8% )。革兰阴性杆菌以肺炎克雷伯杆菌最常见。院内感染革兰阴性杆菌对碳青霉烯类、β-内酰胺酶抑制剂复合物敏感。胎龄 <37周早产儿医院感染率明显高于胎龄 >37周足月儿医院感染率 ,OR值为 3 98(95 %可信区间 :3 0 7～ 5 1 5 ,P <0 0 0 1 )。结论 早产儿是NICU医院感染的高危患儿。坚持严格消毒隔离措施 ,监测医院感染率和病原菌的分布情况 。
Objective To study the characteristics of neonatal nosocomial infection in neonatal intensive care unit(NICU) and the prophylactic strategy. Methods Clinical data of 3?133 neonates admitted to NICU in recent 4 years were analyzed retrospectively for nosocomial infection. Results Two hundred seventy-four infants were complicated with nosocomial infection, with a total hospital infection rate of 8 7%. The main infected site was respiratory tract and it accounted for 50 7% of all neonatal nosocomial infection. Ventilator-associated pneumonia accounted for 20 8%. One hundred and thirty-one pathogens were isolated from 105 patients, with 109 strains of Gram-negative bacilli(83 2%) and 22 strains of Gram-positive cocci(16 8%). Klebsiella pneumoniae was the most common Gram-negative bacilli, which were sensitive to carbopenems and combination of (β-lactamase-inhibitor and antibiotics. The hospital infection rate of infants less than 37 weeks of gestation age was significantly higher than that of term infants greater than 37 weeks of gestation age, with an odd ratio of 3 98(95% confidential interval: 3 07～5 15, P <0 001). Conclusion Premature infants are at high risk for nosocomial infection. Strict sterile isolation precaution should be emphasized. Hospital infection rate and distribution of pathogens should be closely monitored. Strict limitation of prophylactic use of antibiotics helps to lower hospital infection rate.
出处
《广东医学》
CAS
CSCD
2004年第3期260-262,共3页
Guangdong Medical Journal
基金
广东省医药卫生科学研究基金资助项目 (编号 :B2 0 0 2 0 17)
中山大学留学人员启动基金资助项目
