新生儿血管内导管相关感染的临床分析  

Analysis of neonatal Catheter-related bloodstream infection

作　　者：陶连琴[1] 朱婧[1] 谢微微[2] 林振浪[2] 董琳[3] 陈尚勤[2] 

机构地区：[1]温州医学院第二临床医学院,临床医学专业本科生325027 [2]温州医学院附属第二医院新生儿科 [3]温州医学院附属第二医院感染管理科

出　　处：《中国新生儿科杂志》2011年第2期102-105,共4页Chinese Journal of Neonatology

摘　　要：目的探讨新生儿经外周中心静脉置管(PICC)和脐静脉插管(UVC)致血管内导管相关感染(CRBSI)的发生率、危险因素及病原特点。方法 回顾性分析2008年收住我院新生儿重症监护病房(NICU)施行PICC和(或)UVC患儿的临床资料。结果 施行PICC的50例新生儿中有9例发生CRBSI,导管相关血行感染率为6.2/1000血管内导管日(9/1455),施行UVC的111例新生儿中有7例发生CRBSI,导管相关血行感染率为11.6/1000血管内导管日(7/601)。发生CRBSI的危险因素包括出生体重(OR=0.107)、胎龄(OR=0.320)和性别(OR=5.526)(P均<0.05)。多因素Logistic回归分析显示出生体重(OR=0.068,95%CI0.009～0.495)、性别(OR=9.665,95%CI1.976～47.263)是患儿发生CRBSI的独立相关危险因素(P均<0.05)。在检出的病原体中,以凝固酶阴性葡萄球菌为主,占54.5%,主要是多重耐药菌,表现为耐甲氧西林和β内酰胺酶阳性。结论 新生儿发生CRBSI的危险因素为出生体重、胎龄和男婴,致病菌大多为多重耐药菌。Objective To investigate the incidence and etiology of catheter-related bloodstream infection（CRBSI） among neonates with peripheral central venous catheter（PICC） and umbilical vein catheterization（UVC）.Methods Retrospectively analysed 118 infants admitted to our NICU and received PICC and/or UVC between January to December 2008.Results Among 50 infants undergone PICC,9 infants suffered CRBSI,with a 6.2 per 1000 central line days incidence;111 infants underwent UVC,7 infections occurred with a 11.6 per 1000 umbilical line-days.Using univariate non-conditional logistic regression analysis,birth weight（OR=0.107）,gestational age（OR=0.320）,sex（OR=5.526） were significantly related with CRBSI Incidence.They were further analysed by multivariate non-conditional logistic regression.Birth weight（OR=0.068,95% CI 0.009-0.495）,sex（OR=9.665,95% CI 1.976-47.263） were the most significant factors independently associated with incidence of CRBSI.The most common antimicrobial-resistant pathogens were coagulase-negative staphylococci（54.5%）,multi-drug resistant,with MRS and ESBL positive.Conclusions The multi-drug resistant pathogens were commonly seen in CRBSI,causing serious danger to hospitalized infants,especially to those low birth weight infants.

关 键 词：经外周中心静脉置管 脐静脉插管 血管内导管相关感染 

分 类 号：R722.1[医药卫生—儿科]