新生儿重症监护病房医院感染危险因素

目的了解新生儿重症监护病房(NICU)医院感染情况及其危险因素。方法回顾性调查2012年1月—2014年12月某院NICU收治的新生儿,并对其医院感染危险因素进行单因素分析。结果共纳入760例新生儿病例,发生医院感染198例,259例次,医院感染发病率26.05%,例次发病率34.08%,日感染率为9.50‰;医院感染部位主要为下呼吸道(92例次,占35.52%);259例次医院感染病例共检出病原菌172株,以不动杆菌属(40株,占23.26%)为主;胎龄≤32 W、出生体重≤1 500 g、住院时间≥10 d、抗菌药物使用时间≥10 d、进行机械通气、深静脉置管及喂养不耐受的新生儿医院感染发病率较高,差异均有统计学意义(均P0.001)。结论 NICU医院感染发病率高,应针对其危险因素制定有效预防与控制措施,减少新生儿医院感染发生。

Risk factors for healthcare associated infection in a neonatal intensive care unit

ObjectiveTo understand the occurrence and risk factors of healthcare associated infection(HAI) in a neonatal intensive care unit(NICU). MethodsNeonates who were admitted to the NICU of a hospital from January 2012 to December 2014 were investigated retrospectively, risk factors for HAI were performed univariate analysis. ResultsA total of 760 neonates were included in the investigation, 198 neonates developed 259 times of HAI, incidence of HAI was 26.05%，case incidence of HAI was 34.08%，incidence of HAI per 1 000 patient days was 9.50‰； the main infection site was lower respiratory tract （n=92, 35.52%）； among 259 cases of HAI, 172 strains of pathogenic bacteria were isolated, the major pathogen was Acinetobacter spp.(n=40, 23.26%）; incidence of HAI was high in neonates with gestational age ≤32 weeks, birth weight≤1 500 g, length of hospital stay≥10 days, duration of antimicrobial use≥10 days, mechanical ventilation, deep venous catheterization, and feeding intolerance, difference was statistically significant (all P<0.001). ConclusionIncidence of HAI in NICU is high, effective prevention and control measures should be formulated according to its risk factors, so as to reduce the occurrence of HAI in neonates.