新生儿重症监护病房医院感染目标性监测结果分析

目的：了解新生儿重症监护病房（NICU）医院感染规律，以便采取更有效的控制措施。方法：采用2009年《医院感染监测规范》中目标性监测的方法，研究NICU医院感染发病率及部位分布，制定目标监测方案，建立感染监测日志对2011年3月-2012年2月人住NICU的患儿进行前瞻性监测。结果：2011年3月1日-2012年2月29日，NICU共收治危重新生儿444人次，发生医院感染27例次；医院感染例次发病率、目感染率、日感染调整率分别为6．08％、10．29‰、4．28‰，呼吸机相关性肺炎感染率、日感染率、日感染调整率为26．32％，68．49％。、20．82‰；平均病情严重程度为3．29％。感染病例培养出8株病原菌中，G-杆菌占62．5％，G＋球菌占25．0％，真菌占12．5％。结论：胎龄小、体重低、侵人性操作等是NICU中新生儿医院感染的危险因素，通过控制抗菌药物滥用、强调洗手、加强全面消毒等措施，可降低耐药菌及医院感染发生率。

Analysis of Neonatal Intensive Care Unit Hospital Infection Targeted Monitoring Result

Objective： To get to know the hospital infection law of neonatal intensive care unit （ NICU ） so that we can take more effective control measures. Method： Take the targeted monitoring method in 2009 Hospital Infection Surveillance Norms, study the NICU hospital infection incidence and part distribution, develop targeted monitoring program, establish infection surveillance log and carry prospectively monitoring for the children checked in from March 2011 to February 2012. Result： From March 1, 2011 to February 29, 2012, 444 critically ill neonates were treated in NICU, the hospital infection occurred 27 cases; the incidence of hospital infection cases, daily infection rate and daily infection adjusted rate are 6.08%, 10.29 ‰ and 4.28‰ respectively, ventilator-associated pneumonia infection rate, daily infection rate, daily infection adjusted rate are 26.32%, 68.49‰ and 20.82 ‰ respectively; the average disease severity was 3.29%. The infections train eight pathogens, therein, G-bacilli accounts for 62.5%, G＋ cocci accounts for 25.0% and fungal 12.5%. Conclusion： Small gestational age, low body weight, invasive procedures, etc. are the risk factors for neonatal nosocomial infection in the NICU, through the control of antimicrohial drugs abuse, emphasizing hand washing, strengthening comprehensive disinfection and other measures, the drug-resistant bacteria and the incidence of nosocomial infection can be reduced.