早产儿医院感染的临床分析

目的 分析早产儿医院感染发生情况,为医院感染的控制提供依据.方法 回顾性分析2010年1月-2011年12月医院新生儿重症监护病房内住院的231例早产儿临床资料及医院感染发生情况.结果 231例早产儿中发生医院感染者39例,感染率为16.88％,其中男24例占61.54％,女15例占38.46％；医院感染患者住院时间＜7 d者感染率28.21％,≥7d者感染率71.79％,医院感染住院时间比较差异有统计学意义(x2=14.82,P＜0.05)；检出病原菌44株,其中5例存在混合感染,革兰阳性球菌占36.36％,主要以链球菌属及肠球菌属为主,革兰阴性菌占63.64％,主要以肺炎克雷伯菌、大肠埃希菌等为主；医院感染疾病主要是肺炎、泌尿系感染等,导致肺炎的主要病原菌是克雷伯菌属,泌尿系感染病原菌主要为大肠埃希菌、肠球菌属,导致败血症、皮肤感染的病原菌有链球菌属、肠球菌属、溶血葡萄球菌等,坏死性小肠炎患儿病原菌为溶血葡萄球菌、金黄色葡萄球菌.结论 革兰阴性菌是导致早产儿医院感染的主要病原菌,肺炎、泌尿系感染等疾病是临床常见医院感染疾病.

Clinical analysis of nosocomial infections in premature infants

OBJECTIVE To analyze the incidence of nosocomial infections in premature infants and provide basis for the control of nosocomial infections.METHODS The clinical data of 231 premature infants enrolled in neonatal intensive care unit from Jan 2010 to Dec 2011 were retrospectively analyzed,the incidence of nosocomial infections was investigated.RESULTS There were 39 of the 231 premature infants who caught hospital infections with incidence rate of 16.88%,including 24(61.54%) male infants and 15(38.46%) female infants;the incidence of nosocomial infections in the patients with the hospital stay less than 7 days was 28.21%,the patients with hospital stay more than 7 days 71.79%,the difference was statistically significant(χ2=14.82,P<0.05);there were 5 cases with mixed infections,and there were 44 strains isolated,36.36% of which were gram-positive cocci,mainly including Streptococcus and Enterococcus;63.64% of which were gram-negative bacteria,mainly including Klebsiella pneumoniae and Escherichia coli;the pneumonia and urinary tract infections were the common diseases,K.pneumoniae was the main pathogenic bacteria leading to pneumonia,urinary tract infections were mainly caused by E.coli and Enterococcus;Streptococcus,Enterococcus,and S.haemolyticus were the pathogens leading to the sepsis and skin infections,S.haemolyticus and S.aureus were the pathogens causing purulent meningitis.CONCLUSION Gram-negative bacteria are the main pathogens leading to nosocomial infections in the premature infants,the pneumonia and urinary tract infections are the common clinical diseases.