早产儿医院感染败血症的危险因素及病原学分析  

Risk factors and pathogen distribution in premature infants with nosocomial sepsis

作　　者：吴俊[1,2] 吴本清 黄进洁[1,2] 罗亮 唐沂[1,2] 

机构地区：[1]暨南大学第二临床医学院 [2]深圳市人民医院新生儿科,广东深圳518020

出　　处：《中国当代儿科杂志》2012年第2期93-96,共4页Chinese Journal of Contemporary Pediatrics

摘　　要：目的探讨早产儿医院感染败血症的主要危险因素和病原菌分布。方法对2003年1月至2010年12月收治的3418例早产儿进行回顾性分析,对发生医院感染败血症的危险因素进行病例对照研究。结果早产儿医院感染败血症感染率为3.10%(106/3418),发生感染日龄的中位数为19(4～48)d。感染病原菌中革兰阳性菌占45.2%,以凝固酶阴性葡萄球菌的比例较高(24.3%);革兰阴性菌占41.7%,以肺炎克雷伯杆菌为主(25.2%);真菌13.0%。Logistic回归分析提示出生体重、中心静脉置管和肠外营养时间是早产儿院内感染败血症的主要危险因素(OR值分别为3.765、3.051、2.998,均P<0.05)。结论早产儿医院感染败血症的主要危险因素是出生体重、中心静脉置管和肠外营养时间;肺炎克雷伯杆菌是早产儿医院感染败血症的主要病原菌。Objective To investigate the main risk factors and pathogen distribution of nosocomial sepsis among premature infants.Methods The clinical data of 3418 hospitalized premature infants from January 2003 to December 2010 were retrospectively analyzed for the risk factors and pathogen distribution of nosocomial sepsis.Results The incidence of neonatal nosocomial sepsis was 3.10%（106/3418）,and the median age at diagnosis of neonatal nosocomial sepsis was 19（4-48） days.The major pathogens of the infections among these premature infants included gram-positive bacteria（45.2%）,especially coagulase-negative Staphylococcus（24.3%）,and gram-negative bacteria（41.7%）,especially Klebsiella pneumoniae（25.2%）,as well as fungus（13.0%）.Logistic regression analysis showed that the main risk factors included low birth weight,retention of central venous catheters,and long duration of parenteral nutrition（OR： 3.765,3.051,and 2.998,respectively;P0.05）.Conclusions Low birth weight,retention of central venous catheters,and long duration of parenteral nutrition are the main risk factors for neonatal nosocomial sepsis,whereas the leading pathogen is Klebsiella pneumoniae.

关 键 词：医院感染 败血症 危险因素 早产儿 

分 类 号：R722.6[医药卫生—儿科]