新生儿外科多药耐药菌医院感染的相关因素  

Related factors for multidrug-resistant bacteria infections in neonatal surgery department and prevention measures

作　　者：方琼[1] 余雷[1] 向赟[2] 

机构地区：[1]武汉市妇女儿童医疗保健中心新生儿外科,湖北武汉430014 [2]武汉市妇女儿童医疗保健中心检验科,湖北武汉430014

出　　处：《中华医院感染学杂志》2015年第17期4041-4043,共3页Chinese Journal of Nosocomiology

基　　金：湖北省卫计厅基金资助项目(WJ2015MB248)

摘　　要：目的分析新生儿外科多药耐药菌医院感染的相关因素,为制定预防策略提供指导依据。方法对新生儿外科2013年12月-2014年12月收治的1 200例患儿进行前瞻性调查,并对多药耐药菌医院感染的相关因素进行多因素logistic回归分析,并对比预防措施实施前后消毒隔离质量管理效果。结果发生多药耐药菌医院感染的患儿共120例,感染率为10.00%,其中呼吸道感染患儿最多,65例占54.1%;单因素分析结果显示,早产儿/低出生体重儿、住院时间≤2周、侵入性操作、并发症≥2种、抗菌药物使用时间≥12d、糖皮质激素使用时间>12d等与新生儿外科患儿多药耐药菌医院感染的发生具有相关性(P<0.05);多因素logistic回归分析结果显示,住院时间、侵入性操作、并发症种类、糖皮质激素使用时间以及抗菌药物使用时间等为新生儿外科患儿发生多药耐药菌医院感染的独立危险因素。结论新生儿外科患儿的多药耐药菌医院感染率较高,与多种因素有关,主要感染部位是呼吸道,应加强医院感染预防。OBJECTIVE To investigate the related factors for the multidrug-resistant bacteria infections in the neonatal surgery department so as to put forward the prevention countermeasures.METHODS A prospective survey was conducted for 1 200 children who were treated in the neonatal surgery department from Dec 2013 to Dec 2014.The multivariate logistic regression analysis was performed for the related factors for the nosocomial infections due to the multidrug-resistant bacteria,and the effects of disinfection and isolation were observed and compared before and after the prevention measures were carried out.RESULTS The multidrug-resistant bacteria infections occurred in 120 children with the infection rate of 10.00%,of whom 54.1%（65cases）had respiratory tract infections.The results of the univariate analysis indicated that the incidence of the multidrug-resistant bacteria infections in the children of the neonatal surgery department was associated with the preterm or low-birth-weight neonate,length of hospital stay no more than 2weeks,invasive operation,no less than 2types of complications,time of use of antibiotics no less than 12 days,and time of use of glucocorticoids more than 12days（P〈0.05）.The results of the multivariate logistic regression analysis showed that the independent risk factors for the multidrug-resistant bacteria infections included the length of hospital stay,invasive operation,type of complication,time of use of glucocorticoids,and time of sue of antibiotics.CONCLUSIONThe incidence of the multidrug-resistant bacteria infections is high in the children of the neonatal surgery department,which is associated with multiple factors.The respiratory tract is the predominant infection site.It is necessary to strengthen the prevention of the nosocomial infections.

关 键 词：医院感染 多药耐药菌 新生儿外科 危险因素 预防 

分 类 号：R722.13[医药卫生—儿科]