目标性感染监测对新生儿感染干预效果研究  

Effect of targeted surveillance of infections on intervention to neonatal infections

作　　者：古艳云[1] 马静[1] 杨兰菊[1] 张海娇[1] 范书山[1] 

机构地区：[1]聊城市人民医院感染管理科,山东聊城252000

出　　处：《中华医院感染学杂志》2016年第5期1152-1154,共3页Chinese Journal of Nosocomiology

基　　金：中国医院协会医院感染预防与控制基金资助项目(CHA-2012-XSPX-0629-1)

摘　　要：目的回顾性调查及前瞻性目标监测新生儿医院感染特点及高危因素,对比干预前后新生儿感染的效果,为进一步制定新生儿医院感染预防控制措施提供科学依据。方法对2013年1-12月入住新生儿重症监护病房(NICU)的2 003例新生儿,通过HIS、LIS和医院感染实时监控管理系统进行回顾性调查,提取相关数据并进行统计分析;对2014年1-12月入住NICU的1 165例新生儿进行前瞻性监测,包括:出生体质量、胎龄、窒息、气管插管、留置胃管、脐静脉/PICC置管等,并进行评估,在监测评价基础上采取干预措施。结果干预后新生儿医院感染发生率由干预前的7.59%下降至4.89%,呼吸机相关性肺炎发生率由5.34‰下降至1.46‰;导管相关性血流感染率由2.08‰下降至0;新生儿医院感染与胎龄、出生体质量、机械通气时间、气管插管、脐静脉/PICC置管、住院时间、新生儿有无窒息及Apgar评分等因素密切相关,干预前后比较差异均有统计学意义(P<0.05)。结论通过开展目标性监测,主动了解新生儿医院感染情况及危险因素,及时调整并采取针对性的干预措施,可以有效降低新生儿医院感染发生率。OBJECTIVE To conduct the retrospective survey and prospective targeted surveillance of neonates with nosocomial infections and high risk factors and observe the effect of intervention to the neonatal infections so as to provide scientific basis for development of measures to prevention and control the neonatal infections.METHODS A total of 2003 neonates who were hospitalized the neonatal intensive care unit（NICU）from Jan 2013 to Dec 2013 were recruited as the study objects,then the retrospective survey was conducted through the HIS,LIS,and realtime monitoring and management system for nosocomial infections,and the related data were extracted for statistical analysis.The prospective surveillance was carried out for 1 165 neonates who were hospitalized the NICU from Jan 2014 to Dec 2014,including the birth body weight,gestational age,asphyxia,endotracheal intubation,gastric tube indwelling,and umbilical vein/PICC intubation,the results were evaluated,and the intervention measures were taken based on the evaluation of the surveillance.RESULTS The incidence rate of neonatal nosocomial infections dropped from 7.59% before the intervention to 4.89%after the intervention;the incidence of ventilator-associated pneumonia decreased from 5.34‰ to 1.46‰;the incidence rate of catheter-related bloodstream infections dropped from 2.08‰ to 0.The incidence of the neonatal nosocomial infections was closely associated with the gestational age,birth body weight,mechanical ventilation duration,endotracheal intubation,umbilical vein/PICC intubation,length of hospital stay,asphyxia and Apgar score,and there was significant difference before and after the intervention（P〈0.05）.CONCLUSIONIt is an effective way to conduct the targeted surveillance,actively understand the prevalence of neonatal nosocomial infections and the high risk factors,and adjust and take targeted intervention measures so as to reduce the incidence of neonatal nosocomial infections.

关 键 词：目标性监测 新生儿 感染 干预措施 

分 类 号：R722.13[医药卫生—儿科]