社区新生儿皮肤感染的相关因素调查  

Factors related to neonatal skin infection in community

作　　者：李严平[1] 宋凤丽[2] 史伟[2] 陈景芝 马琳[4] 马秀华[2] Li Yanping;Song Fengli;Shi We;Chen Jingzhi;Ma Lin;Ma Xiuhua(Department of General Practice,People's Hospital of Beijing Daxing District,Beijing 102600,China;Department of Obstetrics,People's Hospital of Beijing Daxing District,Beijing 102600,China;Clinical Laboratory,People's Hospital of Beijing Daxing District,Beijing 102600,China;Department of Dermatology,Beijing Children's Hospital,Belting 100045,China)

机构地区：[1]北京市大兴区人民医院社区科,102600 [2]北京市大兴区人民医院产科,102600 [3]北京市大兴区人民医院检验科,102600 [4]北京儿童医院皮肤科,100045

出　　处：《中华全科医师杂志》2018年第11期914-917,共4页Chinese Journal of General Practitioners

摘　　要：2016年1-12月对社区中出生28d以内的新生儿进行访视,观察新生儿有无皮肤感染,对有皮肤感染者,记录新生儿的感染部位,采集家庭看护人员手、鼻腔的皮肤样本以及家庭看护人员最常接触的部位,如水龙头、手机、马桶按钮等进行涂抹采样,通过作细菌培养及菌株鉴定,全面分析新生儿皮肤感染与家庭环境及看护人员所携带的微生物情况及其可能存在的联系。共访视1452名新生儿,存在皮肤感染27例,其中男性12例,女性15例。感染疾病以脐炎为多(11例),其次是毛囊炎(9例)、脓疱疮(7例)。感染部位共计36处,以颈部(12例)、腋窝(7例)和脐周(7例)为多。病原菌以金黄色葡萄球菌(20例)和大肠埃希菌(7例)为主,其中有2例耐甲氧西林金黄色葡萄球菌。家庭环境中及家庭看护人员检出金黄色葡萄球菌与新生儿皮肤金黄色葡萄球菌感染均存在相关性(X^2=678.808、820.396,P<0.01)。7例大肠埃希菌感染患儿中其家庭看护人员或是家庭环境中均培养出大肠埃希菌。提示新生儿家庭看护人员及家庭环境与新生儿皮肤感染密切相关,提高家庭看护人员的消毒隔离意识及改善家庭环境的卫生情况对减少新生儿皮肤感染十分重要。Total 1 452 newborns were home visited within 28 d after birth during January 2016 to December 2016,and 27 cases of skin infections were found.Umbilical inflammation was more common (11 cases),followed by folliculitis (9 cases) and impetigo (7 cases).Samples were collected for bacterial culture and identification from the skin of infected newborns,the hands and nasal cavity of family baby caretakers,and household articles,including faucets,mobile phones,toilet buttons and so on.The pathogens identified were Staphylococcus aureus in 20 cases (including 2 methicillin-resistant strains) and Escherichia coli in 7 cases.The isolation of Staphylococcus aureus in household articles was significantly correlated with newborns infected with Staphylococcus aureus (x2=678.808,P＜0.01);and the isolation of Staphylococcus aureus from family baby caretakers was also significantly associated with neonatal Staphylococcus aureus infection (x2=820.396,P＜0.01).In 7 cases of Escherichia coli infection,the Escherichia coli were detected from samples of baby caretakers or household articles.The study suggests that the awareness of baby caretakers and home hygiene are important to reduce neonatal skin infections.

关 键 词：新生儿 皮肤感染 家庭环境 家庭看护人员 

分 类 号：R722.1[医药卫生—儿科]