NICU医院感染患者的病原学分布及危险因素分析

目的了解神经外科重症监护病房(NICU)医院感染的病原菌分布特点及相关危险因素,为防治医院感染提供有效的参考。方法对NICU2007-01-2009-02121例医院感染患者送检标本细菌培养结果进行统计分析。结果从121例患者1280份标本中共分离出病原菌202株,主要来源于下呼吸道、各种引流管、泌尿道等。其中G-菌占61.38%,以杆菌为主;G+菌占27.22%,以葡萄球菌为主;真菌占11.38%。结论 NICU医院感染主要以G-杆菌引起的下呼吸道为主,可能与侵入性操作、神经功能受损致生理功能受到抑制、颅内压高致频繁的呕吐导致误吸、患者的机体抵抗力下降、广谱抗菌药物的不合理使用等有一定的关系。

Clinical analysis and measures of prevention and manipulation of hospital infections in the neonatal intensive care unit

Objective To comprehend the distributed character of pathogenic bacteria of hospital infections in the neonatal intensive care unit.Methods We collected specimens from 121 hospital infections in my neonatal intensive care unit from January 2007 to January 2009 and assayed the outcomes of drug sensitive test and bacterial culture of 1 280 specimens.Results 202 pathogenic bacteria strains were dissected from 1 280 specimens,which mainly came from lower respiratory tract、various kinds of drain pipes urinary tract、blood、gastrointestinal tract、skin、soft tissues and intracalvarium,there were 124 G-bacteriums（61.38%）,55 G＋ bacteriums（27.22%）,and 23 fungus（11.38%）;the most of G-bacteriums were pseudomonas aeruginosa（27.72%）,all of G＋ bacteriums,staphylococcus aureus accounted for 12.37%,9 specimens were candida albicans in 23 fungus（4.45%）.Conclusions The pathogenic bacterias of hospital infections in neonatal intensive care unit mainly come from lower respiratory tract,there are many risk factors such as invasive manipulations、physiologic functions are inhibited because of damage of nervous function、frequently vomiting because of intracranial pressure increasing,which resulted in aspiration、the descend of resistance、the illegitimate usage of broad spectrum antibiosis and so on,that have an invariably relationship with hospital infections in neonatal intensive care unit.