NICU新生儿医院感染特点与病原菌分析  

Characteristics of nosocomial infections in neonates of NICU and distribution of pathogens

作　　者：高杰[1] 李英[1] 谌丽娟[1] 吴静[1] 秦凌雁 

机构地区：[1]河南大学淮河医院儿科,河南开封475000

出　　处：《中华医院感染学杂志》2016年第2期427-428,437,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技攻关基金资助项目(01140512)

摘　　要：目的探讨新生儿重症监护病房(NICU)医院感染特点并对常见病原菌进行分析,为临床NICU医院感染的预防及治疗提供依据。方法选取医院2013年4月-2015年4月NICU收治的新生儿650例为研究对象,对其中发生医院感染的46例新生儿进行研究,观察其医院感染特点,对新生儿痰液、血液标本进行培养,观察病原菌分布;采用美国BD公司的细菌培养鉴定仪对细菌进行鉴定;采用SPSS17.0软件对数据进行统计分析。结果650例新生儿中发生医院感染46例,发生率为7.08%,常见感染部位依次为呼吸道感染、口腔和血液,少数新生儿表现为泌尿道及皮肤感染;46例感染新生儿共分离出病原菌61株,其中革兰阴性菌37株占60.65%,以大肠埃希菌和肺炎克雷伯菌为主,革兰阳性菌20株占32.79%,以酿脓链球菌和金黄色葡萄球菌为主,真菌4株占6.56%。结论新生儿医院感染率低,主要为呼吸道感染;检出病原菌以革兰阴性菌为主,临床医护人员需要严格把控手卫生,掌握机械通气指征,执行无菌操作,避免反复插管,缩短机械通气时间,以预防及控制医院感染的发生。OBJECTIVE To explore the characteristics of nosocomial infections in neonates of neonatal intensive care unit（NICU）and investigate the distribution of common pathogens so as to provide guidance for prevention and treatment of the nosocomial infections in the NICU.METHODS A total of 650 neonates who were treated in the NICU from Apr 2013 to Apr 2015 were recruited as the study objects,and 46 neonates with nosocomial infections were investigated.The characteristics of the nosocomial infections were observed,the sputum and blood specimens obtained from the neonates were cultured,and the distribution of the pathogens was analyzed.The strains were identified by using the bacterial culture and identification system of BD company,the United States,and the statistical analysis of data was performed with the use of SPSS17.0software.RESULTS Of 650 neonates,46had the nosocomial infections with the incidence rate of 7.08%;the respiratory tract,oral cavity,and blood were the common infection sites,and few of the neonates had urinary tract and skin infections.Totally 61 strains of pathogens were isolated from the 46 neonates with the infections,including 37（60.65%）strains of gram-negative bacteria,20（32.79%）strains of gram-positive bacteria,and 4（6.56%）strains of fungi;the Escherichia coli and Klebsiella pneumoniae were dominant among the gram-negative bacteria;the Streptococcus pyogenes and Staphylococcus aureus were the predominant species of the gram-positive bacteria.CONCLUSIONThe incidence rate of the nosocomial infections is low in the neonates,and the respiratory tract is the major infection site.The gram-negative bacteria are dominant among the isolated pathogens.It is necessary for the health care workers to strictly follow the hand hygiene,master the indications for mechanical ventilation,and implement the aseptic operation so as to avoid the repeated intubation,shorten the mechanical ventilation duration,and control the nosocomial infections.

关 键 词：新生儿重症监护病房 医院感染 病原菌 

分 类 号：R378[医药卫生—病原生物学]