新生儿医院感染相关因素分析  

Related factors for nosocomial infections in neonates

作　　者：母绍琼 朱斌[1] 姚君[1] 陈蓉[1] 曾玲[1] 

机构地区：[1]广元市第一人民医院院感科,四川广元628017

出　　处：《中华医院感染学杂志》2013年第20期4961-4963,共3页Chinese Journal of Nosocomiology

基　　金：四川省广元市科研计划项目(2012027)

摘　　要：目的探讨新生儿医院感染的相关因素,为预防新生儿医院感染提供依据。方法选择2011年2月-2013年2月医院819例新生儿作为研究对象,对新生儿的医院感染率进行统计,对感染部位以及病原菌分布进行分析,对新生儿的性别、胎龄、体重、是否使用呼吸机、采用母乳喂养、有侵入性操作、基础疾病及使用抗菌药物等临床资料进行回顾性分析。结果 819例新生儿中有71例发生医院感染,感染率8.67%;感染部位主要为呼吸道占52.1%,其次为消化道和泌尿道;病原菌分布主要为革兰阴性菌39株,占54.9%;革兰阴性菌对亚胺培南和哌拉西林的敏感性较高,>75.00%,革兰阳性菌对万古霉素的敏感性较高,达100.0%;胎龄<32周、出生时体重<2.5kg、使用呼吸机、未采取母乳喂养、有侵入性操作、基础疾病及使用广谱抗菌药物的患儿更易获得医院感染,差异有统计学意义(P<0.05)。结论对于早产儿、低体重儿、非母乳喂养、有基础疾病、使用呼吸机、有侵入性操作、使用广谱抗菌药物的患儿,要给予充分的重视并采取相应的措施,防止医院感染的发生。OBJECTCE To explore the related factors for nosocomial infections in neonates and statistically analyze the species of pathogens causing infections and the infection sites so as to provide guidance for prevention of nosocomial infections in the neonates. METHODS A total of 819 neonates who were treated in the hospital from Feb 2011 to Feb 2013 were enrolled in the study, then the incidence of nosoeomial infections in the neonates was statistically analyzed, the distribution of the infection sites or the pathogens was observed, and the clinical data, including the age, gender, body weight, use of ventilator, breastfeeding, invasive operation, complication of underling disease, and use of antibiotics, were retrospectively analyzed. RESULTS Of totally 819 neonates investigated, the nosocomial infections occurred in 71 cases with the infection rate of 8. 67~, among which the cases of respiratory tract infections accounted for 52.1 ~/~0, followed by the cases of gastrointestinal tract infections or urinary tract infections. Of the pathogens isolated, there were 39 （54.90/~） strains of gram-negative bacteria. The gram-negative bacilli were highly susceptible to imipenem and piperacillin, while the gram-positive bacteria were highly susceptible to vancomycin. The neonates with gestational age lees than 32 weeks, birth weight less than 2. 5 kg, use of ventilator, without breastfeeding, invasive operation during treatment, complication of underlying disease, or use of broad spectrum antibiotics were more vulnerable to the nosocomial infections, the differences were significant （P（0. 05）. CONCLUSION It is necessary to be fully aware of the neonates with preterm birth, low birth weight, without breastfeeding, complication of underlying disease, use of ventilator, invasive operation, and use of broad spectrum antibiotics and to take corresponding measures so as to prevent the nosocomial infections.

关 键 词：新生儿 医院感染 相关因素 分析 

分 类 号：R722.13[医药卫生—儿科]