中国大陆地区新生儿医院感染部位发生情况的Meta分析  

The distribution of nosocomial infection sites among neonate in China:Meta analysis

作　　者：黄娅铃[1] 曾子耘[2] 米久雪 李迎丽[1] 邱景富[1] 

机构地区：[1]重庆医科大学公共卫生与管理学院,重庆400016 [2]中国人民解放军324医院普外科,重庆400000 [3]重庆医科大学附属第二医院骨科,重庆400010

出　　处：《现代预防医学》2015年第16期3036-3039,3056,共5页Modern Preventive Medicine

基　　金：国家自然科学基金(31170129;31200064)

摘　　要：目的运用循证方法探讨中国大陆地区新生儿医院感染各部位发生及分布情况。方法系统检索建库至2013年在CNKI、CBM、VIP、Wan Fang data及Pub Med上有关中国大陆地区新生儿医院感染调查的文献,纳入合格研究。根据异质性检验结果,采用合适的模型对原始数据进行合并分析。结果共纳入147篇合格文献,中国大陆地区新生儿院内感染部位分析结果表明：总感染率和总分布率最高部位均为下呼吸道,分别为16‰（95%CI：13‰～19‰）和27%（95%CI：21%～32%）。分组分析结果显示：按医院分类和等级分析,感染率最高部位在综合性医院为下呼吸道21‰（95%CI：17‰～24‰）,在专科医院为胃肠道12‰（95%CI：10‰～14‰）;在三级、二级及以下等级医院均为下呼吸道15‰（95%CI：12‰～18‰）、18‰（95%CI：13‰～22‰）。按地区分析,感染率最高部位在东部、中部地区医院为下呼吸道16‰（95%CI：12‰～21‰）、17‰（95%CI：12‰～21‰）,在西部地区医院为口腔黏膜17‰（95%CI：12‰～21‰）。按时间分析,1985-1999年感染率最高部位为口腔黏膜19‰（95%CI：12‰～27‰）,2000-2013年感染率最高部位为下呼吸道17‰（95%CI：13‰-20‰）。结论新生儿医院感染中呼吸道为最常见的感染部位,但不同医院有各自的特殊性,因此每个医院应结合自己的具体情况采取相应措施来预防和减少新生儿院内感染的发生。Objective This work was to investigate the distribution of nosocomial infection（NI） sites among neonate in China through evidence-based method. Methods Relevant articles were searched on CNKI, CNM, VIP, Wanfang database and Pub Med from the establishing date of the databases to Dec. 2013.The qualified study was screened. The related data were combined with R software and the appropriate effects model was employed according to statistical test of homogeneity. Results Finally, 147 studies were included. The highest infection rate and the highest distribution rate of NI sites among neonates in China were all occurred to lower respiratory tract with 16 ‰（95%CI： 13‰-19 ‰） for infection rate and 27%（95%CI： 21%-32%） for distribution rate, respectively.Grouping analysis showed the NI sites with the highest infection rate was lower respiratory tract with 21‰（95%CI： 17‰-24‰） in general hospital, and 12 ‰（95%CI： 10 ‰-14 ‰） in special hospital. According to the hospital classification, it showed that the site with the highest infection rate was lower respiratory tract both in the three level hospital 15‰（95%CI： 12‰-18‰） and in the two and below grade level hospital 18‰（5%CI： 13‰-22‰）. According to geographical region, the NI sites with the highest infection rate was lower respiratory tract both in the eastern region 16‰（95%CI： 12‰-21‰） and in the central region 17‰（95%CI： 12‰-21‰）, while it was oral mucosa in the western region 17‰（95% CI： 12‰-21‰）. According to the time when the infections occurred, the sites with the highest infection rate was oral mucosa 19‰（95%CI： 12‰-27‰） in 1985-1999, and lower respiratory tract 17‰（95%CI： 13‰-20‰） in 2000-2013. Conclusion The most common NI site among neonates was respiratory tract, but each hospital has its own particularity. So decision should be made based on the specific circumstances of each hospital.

关 键 词：新生儿 医院感染 部位 META分析 

分 类 号：R17[医药卫生—妇幼卫生保健]