新生儿医院感染目标性监测及细菌耐药性分析  

Objective Monitoring of Neonatal Nosocomial Infection and Analysis of Antibiotic Resistance

作　　者：李荣[1,2] 王路[2] 张海金[2] 闫永平[1] 

机构地区：[1]第四军医大学流行病学教研室,西安710032 [2]西安市儿童医院医院感染管理科

出　　处：《华西医学》2014年第8期1491-1493,共3页West China Medical Journal

基　　金：陕西省卫生厅科研基金(2010H19)~~

摘　　要：目的探讨新生儿医院感染的危险因素及病原菌耐药情况,为医院感染控制提供依据。方法对2012年1月-12月住院48 h以上的新生儿进行医院感染目标性监测及感染因素分析。结果新生儿共发生54例医院感染,感染发病率为1.25%,发生部位依次为呼吸道(占66.7%)、胃肠道(占18.5%)、皮肤软组织(占9.2%)。出生体质量越低(χ2Trend=126.88,P<0.001)、住院时间越长(χ2Trend=106.89,P<0.001),发生医院感染的比例或风险越高;有侵袭性操作的新生儿发生医院感染的风险增高(χ2=5.338,P=0.021);新生儿医院感染与性别无关(χ2=0.984,P=0.321)。在54例新生儿医院感染患儿体内共分离出54株病原菌,其中G+菌23株,占42.6%,主要G+菌对青霉素及大环内酯类抗生素普遍耐药;G-菌31株,占57.4%,G-菌对第3代头孢菌素类抗生素耐药性最高。结论新生儿医院感染发病率较低,出生体质量、住院时间及侵袭性操作是新生儿发生院内感染的危险因素。Objective To explore the risk factors for neonatal nosocomial infection and the pathogen resistance, in order to provide the basis for hospital infection control. Methods Surveillance of hospital infection in newborns hospitalized for more than 48 hours were carried out from January to December 2012, and the risk factors for hospital infection were analyzed. Results There were 54 newborn cases with neonatal nosocomial infection, and the infection rate of newborns was 1.25%. The major infection sites were respiratory tract（66.7%）, gastrointestinal tract（18.5%）, skin and soft tissues（9.2%）. Birth weight（χ^2 Trend=126.88, P〈0.001）, hospitalization days（χ^2 Trend=106.89, P〈0.001）, invasive operation（χ^2=5.338, P=0.021） were the major risk factors. A total of 54 strains of pathogenic bacteria were isolated from 54 newborn cases with neonatal nosocomial infection. Twenty-three strains of gram-positive bacteria accounted for 42.6%, which were generally resistant to penicillin and large ring lactone class antibiotic drugs. Thirty-one strains of gram-negative bacteria accounted for 57.4%, which were mainly resistant to the three generations of cephalosporins. Conclusion The hospital infection rate of newborns is low. Birth weight, hospitalization days and invasive operation are the major risk factors for neonatal nosocomial infection.

关 键 词：新生儿 医院感染 危险因素 耐药性 

分 类 号：R722.1[医药卫生—儿科]