新生儿呼吸窘迫综合征院内感染44例临床分析

目的：分析新生儿呼吸窘迫综合征（NRDS）院内感染的临床特点、危险因素,为制定防治措施提供依据。方法：对2011年3月至2013年9月我院NICU收治的第一诊断为NRDS的238例患儿的临床资料进行回顾性分析,根据发生院内感染（44例）和未发生院内感染（194例）进行院内感染部位、危险因素及病原菌的分析。结果：NRDS患儿的院内感染率为18.49%,住院相关院内感染率为8.5例次/千日,机械通气相关院内感染率为14.4例次/千日,中心静脉置管相关院内感染率为0.3例次/千日;感染部位以血液为主（48.89%）,其次为呼吸道（33.33%）;病原菌以革兰阴性菌为主（76.19%）,其中肺炎克雷伯菌占40.48%。结论：NRDS院内感染发生率明显高于其他疾病院内感染发生率。胎龄小、出生体质量低、肠外营养等是发生院内感染的危险因素。

Clinical Analysis of 44 Cases Nosocomiai Infection in Neonatal Respiratory Distress Syndrome

Objective： To study the clinical feature and risk factors, and provide the basis for prevention and control measures of nosocomial infection in neonatal respiratory distress syndrome（NRDS）. Methods： A retrospectively analysis of 238 cases with neonatal respiratory distress syndrome in neonatal intensive care unit from Mar 2011 to Sept 2013 was preformed. According to the occurrence of nosocomial infection, all the children were divided into two groups, 44 cases occured nosocomial infection and 194 cases did not occur nosocomial infection, then analyzed nosoeomial infection site, infection pathogen and the risk factors. Results： The nosocomial infection rate of NRDS was 18.49% , the hospitalized related infection rate was 8.5 cases per 1 000 days; mechanical ventilation related infection rate was 14.4 cases per 1 000 days; central venous catheter related infection rate was 0.3 cases per 1 000 days. The main infection site was blood infections （48.89%）, followed by respiratory tract infections （33.33%） ; the main bacterium was Gram-negative bacteria （76. 19% ） , Klebsiella pneumonia was the major pathogen causing nosocomial infections （40.48%）. Conclusion： NRDS nosocomial infection is obviously higher than that of other diseases. The risk factors associated with nosocomial infection are as follows： mall for gestational age, low birth weight, parenteral nutrition and so on.