NICU医院感染特点与目标性监测分析

目的 探讨新生儿医院感染特点,为其感染的预防提供科学依据.方法 对入住新生儿重症监护病房(NICU)＞48 h的患儿开展医院感染的目标性监测,同时采取插管相关感染的一系列综合(Bundle)预防控制措施,对监测结果及插管相关性感染进行分析.结果 在监测的498例重症新生儿7629个住院日中,医院感染发病率为10,90％,患儿日感染率为7.08‰；血管插管和呼吸机使用率分别为23.69％和18.06％,未发生血管插管相关性感染,但呼吸机相关性肺炎的患儿日发生率为2.9％；感染率与出生体重密切相关；常见感染部位为下呼吸道、胃肠道,常见病原菌为肺炎克雷伯菌、表皮葡萄球菌和屎肠球菌.结论 新生儿医院感染与患儿出生体重密切相关,采取控制措施可有效预防.

Characteristics of nosocomial infections in NICU and targeted monitoring

OBJECTIVE To explore the characteristics of nosocomial infections in the neonates so as to provide scientific bases for the prevention of infections.METHODS Targeted surveillance was carried out for the neonates enrolled in NICU over 48 hours and discharged from NICU in 48 hours,at the same time "bundle" control measures for central line-associated bloodstream infection(CLABSI) and ventilator-associated pneumonia(VAP) were conducted.The surveillance results and the catheter-associated infections were analyzed.RESULTS Of 498 neonates with 7629 patient days,the incidence of nosocomial infection was 10.90%,the daily infection rate was 7.08‰.The utilization rates of the intravascular catheter and the ventilator were 23.69% and 18.06%,respectively,there was no catheter-related infections,the incidence of ventilator-associated pneumonia per patient day was 2.9‰;the infection rate was closely related to the birth weight;the major infection sites were the lower respiratory tract and gastrointestinal tract,and the common pathogens were Klebsiella pneumoniae,Staphylococcus epidermidis and Enterococcus faecium.CONCLUSION The nosocomial infection in the neonates is closely related to the birth weight,which can be effectively prevented by taking control measures.