新生儿重症监护病房医院感染流行病学多中心研究  

Multicenter study on epidemiology of healthcare-associated infection in neonatal intensive care units

作　　者：贾会学[1] 殷环[1] 吴安华[2] 胡必杰[3] 张秀月[4] 侯铁英[5] 宗志勇[6] 李卫光[7] 杨怀[8] 杨芸[9] 刘运喜[10] 文建国[11] 陆群[12] 李六亿[1] 

机构地区：[1]北京大学第一医院,北京100034 [2]中南大学湘雅医院,湖南长沙410008 [3]复旦大学附属中山医院,上海200032 [4]中国医科大学附属盛京医院,辽宁沈阳110004 [5]广东省人民医院,广东广州510008 [6]四川大学华西医院,四川成都610041 [7]山东省立医院,山东济南250021 [8]贵州省人民医院,贵州贵阳550002 [9]山西医学科学院山西大医院,山西太原030001 [10]解放军总医院,北京100853 [11]郑州大学第一附属医院,河南郑州450052 [12]浙江大学医学院附属第二医院,浙江杭州310009

出　　处：《中国感染控制杂志》2015年第10期649-653,共5页Chinese Journal of Infection Control

基　　金：中国医院协会医院感染预防与控制能力建设项目(CHA-2012-XSPX-0629-1)

摘　　要：目的了解我国三级甲等综合医院新生儿监护病房(NICU)医院感染的流行特点,为预防和控制新生儿医院感染提供科学依据。方法以多中心研究的方式,选取全国9省17所医院,按照统一的诊断标准和方法对2013年10月—2014年9月NICU住院新生儿的医院感染情况进行前瞻性监测。结果共监测12 998例NICU住院新生儿,发生436例次医院感染,例次发病率为3.35%,住院总日数为126 125 d,日发病率为3.46‰。新生儿医院感染例次发病率随新生儿出生体重的增加而下降(χ2=291.55,P<0.001)。不同规模NICU新生儿医院感染发病率比较,差异有统计学意义(χ2=49.77,P<0.001),床位数>30张的NICU新生儿医院感染例次发病率和日发病率最高;NICU新生儿医院感染例次发病率以西南地区(10.36%)最高,日发病率以华南地区(10.52‰)最高。感染部位以下呼吸道和血液为主;感染病原体以肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌为主。结论我国NICU不同出生体重组、不同规模、不同地区的新生儿医院感染发病率不同,应继续加强监测,根据感染特点指导各项防控措施的落实。Objective To investigate the epidemiological characteristics of healthcare-associated infection（HAI）in neonatal intensive care units（NICUs）of tertiary first-class hospitals in China,and provide scientific evidence for the prevention and control of neonatal HAI.Methods 17 hospitals in 9 provinces were selected for multicenter study,HAI occurred in neonates at NICUs from October 2013 to September 2014 were surveyed prospectively according to the uniform diagnostic criteria and methods.Results A total of 12 998 neonates were monitored,436（3.35%）HAI cases occurred,the total patient-days were 126 125 days,incidence of infection was 3.46/1 000 patient-days.HAI cases rate decreased with the increase of birth weight（χ^2=291.55,P〈0.001）.The difference of HAI rate in neonates at different sizes of ICUs were significantly different（χ^2=49.77,P〈0.001）,infection case rate and infection incidence per 1 000 patient-days were both highest in NICUs with〉30 beds;HAI case rate was highest in southwest region（10.36%）,infection rate per 1 000 patient-days was the highest in southern China（10.52‰）.Lower respiratory tract and bloodstream were the main infection sites;the major pathogens for infection were Klebsiella pneumoniae,Escherichia coli,and Acinetobacter baumannii.Conclusion The incidences of HAI in NICUs are different among neonates of different birth weight,at different sizes of ICUs,and at ICUs of different regions,surveillance should be strengthened,prevention and control measures should implemented according to infection characteristics.

关 键 词：新生儿监护病房 NICU 医院感染 例次感染率 日感染率 流行病学 多中心研究 

分 类 号：R181.32[医药卫生—流行病学] R722[医药卫生—公共卫生与预防医学]