新生儿重症监护病房院内感染高危因素分析及防治策略

目的：探讨新生儿重症监护病房（NICU）院内感染的高危因素，总结提出防治干预策略供临床参考。方法：采用回顾性研究方法，通过医院信息系统（HIS）收集2012年6月至2016年6月我院NICU发生院内感染的319例新生儿的临床资料。结果：我院NICU院内感发生率为7.00%（319/4 557）。319例发生院内感染的新生儿中，早产儿225例（70.53%），胎龄（32.54±2.31）周，出生体质量（1 825.81±635.32）g，发生院内感染的时间为入住NICU后3~36（12.56±9.00）d，病死率5.33%（17/319）。NICU院内感染与多种因素有关，其中，侵入性操作（气管插管、PICC等）、极低出生体质量、基础疾病、医源性传播是高危因素。结论：加强科室规范管理、提高医护人员的院内感染防控意识、严格无菌操作等，能减少NICU院内感染的发生。

Analysis of Correlation High Risk Factors and Prevention Strategies of Infants with Nosocomial Infection in Neonatal Intensive Care Unit

Objective: To investigate correlation high risk factors and prevention strategies of nosocomial infection in neonatal intensive care unit (NICU). Methods: A case-control study was performed. Totally 319 infants with nosocomial infection in NICU of our hospital from June 2012 to June 2016 were retrospectively analyzed. Results: 319 case files of infants with nosocomial infectin were retrieved from 4557 case files, the nosocomial infection rate was 7.0 percent, 225 premature infants (70.5%), the average of gestational age was (32.54±2.31) weeks, the average of birth weight was (1,825.81±635.32)g; the average time of nosocomial infection was (13.26±8.70) d; the mortality of nosocomial infection was 5.33%. Nosocomial infection in NICU was related with multiple factors, such as invasive operation (tracheal intubation, peripherally inserted central catherization (PICC)), very low birth weight infant, basic diseases and iatrogenic transmission were high risk factors of nosocomial infection in NICU. Conclusions: Strengthening management, enforcing the sterile operation, doing basic nursing, these management and prevention work should be enhanced to reduce nosocomial infection rate in NICU according to those high risk factors.