连续3年某院新生儿科医院感染监测

目的了解某院新生儿科医院感染情况,为更好地控制新生儿医院感染提供参考依据。方法采用前瞻性调查方法,对2011年1月—2013年12月某院新生儿科住院的所有新生儿进行目标性监测。结果共监测新生儿5 365例,发生医院感染128例,133例次,医院感染率为2.39%,例次感染率为2.48%。医院感染部位以眼结膜居首位,占33.08%,其次是上呼吸道、皮肤及软组织,分别占23.31%和17.29%。新生儿日感染率为3.32‰(128/38 528),血管导管使用率为1.75%(676/38 528),呼吸机使用率为1.09%(420/38 528)。不同体重组新生儿血管导管使用率、呼吸机使用率比较,差异均有统计学意义(χ2值分别为3 075.22、442.46,均P0.01)。体重≤1 000 g、1 001~1 500 g、1 501~2 500 g、2 500 g各组新生儿医院感染率分别为16.67%、12.26%、4.15%、1.06%。新生儿均未发生导管相关性血流感染,且其呼吸机相关性肺炎发病率仅为4.76‰(2/420)。共送检标本51份,检出病原菌27株,以革兰阳性菌为主(占55.56%)。结论低体重新生儿医院感染发病率较高;新生儿感染部位以眼部、上呼吸道、皮肤及软组织为主。

Surveillance on healthcare associated infection in a neonatal intensive care unit of a hospital for three consecutive years

ObjectiveTo investigate healthcare associated infection (HAI) in neonatal intensive care unit(NICU), and provide reference for controlling HAI in newborns. MethodsTargeted surveillance on HAI in all newborns in NICU of a hospital from January 2011 to December 2013 was performed by  prospective investigation method.  ResultsA total of  5 365 newborns were monitored, 128 newborns developed 133 times of HAI,HAI rate and HAI case rate was 2.39% and 2.48% respectively. The major infection sites were conjunctiva (33.08%), upper respiratory tract (23.31%) and  skin soft tissue (17.29%). The daily infection rate was 3.32‰(128/38 528), vascular catheter usage rate and respirator usage rate was 1.75%（676/38 528）and 1.09%（420/38 528）respectively. The difference in vascular catheter usage rate and respirator usage rate in newborns with different body weight had statistical difference (χ2=3 075.22; 442.46, both P＜0.01）. HAI in newborns with body weight of ≤1 000 g, 1 001-1 500 g, 1 501-2 500 g, and ＞2 500 g was 16.67%,12.26%,4.15% and 1.06% respectively. None newborns developed catheter related bloodstream infection(CRBSI), the incidence of ventilator-associated pneumonia (VAP) was only 4.76‰（2/420）. A total of 51 specimens were sent for detection, 27 pathogens were isolated, the major were gram positive bacteria（55.56%）.ConclusionThe incidence of HAI in newborns is high,  the main infection sites are eye, upper respiratory tract, and skin and soft tissue.