新生儿重症监护病房血管内导管相关感染调查分析  

Investigation and analysis of intravascular catheter-related infection in neonatal intensive care unit

作　　者：何源[1] 唐艳林[1] 易海英 杨树杰[1] HE Yuan TANG Yanlin YI Haiying YANG Shujie(Department of Neonatology, Xiaogan Central Hospital in Hubei Province, Xiaogan 432000, Chin)

机构地区：[1]湖北省孝感市中心医院新生儿科,湖北孝感432000

出　　处：《中国现代医生》2017年第33期85-88,共4页China Modern Doctor

摘　　要：目的调查分析新生儿病房156例新生儿血管内导管相关感染的发生率、病原菌的分布特点。方法收集2014年1月~2016年12月我院新生儿科住院治疗并接受经外周置入中心静脉导管和(或)脐静脉导管患儿的临床资料,分析血管内导管相关感染的发生率、病原菌种类和特点。结果 156例患儿中,侵入性操作191例次,血管内导管相关感染47例次(24.6%),感染发生率为20/1000置管日,导管定植感染率为9.8/1000置管日,局部感染率为4.7/1000置管日,CRBSI为5.5/1000置管日。随着出生体重及胎龄的增加,CRBSI发生率呈下降趋势(P<0.05)。血管内导管相关感染的病原菌以凝固酶阴性葡萄糖球菌为主(34.0%),其次分别为金黄色葡萄球菌(21.3%),表皮葡萄球菌(17.0%),肺炎克雷伯杆菌(10.6%),阴沟肠杆菌(6.4%),大肠埃希氏菌(6.4%),白假丝酵母菌(4.3%)。结论通过分析新生儿重症监护病房内血管内导管操作相关感染状况及病原菌的分布,采取适宜的干预措施,有助于降低院内感染的发生,改善患儿预后。Objective To investigate and analyze the incidence rate of neonatal intravascular catheter-related infections and the distribution characteristics of pathogens in 156 neonates in neonatal ward. Methods From January 2014 to De- cember 2016, the clinical data of infants who were hospitalized in the Department of Neonatology and were given peripherally inserted central catheter and/or umbilical vein catheters were collected. The incidence of intravascular catheter-related infections and pathogen species and characteristics were analyzed. Results Of the 156 infants, there were 191 cases undergoing invasive procedures, 47 cases with intravascular catheter-related infection （24.6%）. The incidence rate of infections was 20/1000 catheterization day, the infection rate of catheter colonization was 9.8/1000 catheterization day, local infection rate was 4.7/1000 catheterization day, and CRBSI was 5.5/1000 catheterization day. With the increase of birth weight and gestational age, CRBSI rate was decreased （P〈0.05）. Intravascular catheter-related infection pathogens were mainly coagulase-negative staphylococci（34.0%）, followed by Staphylococcus aureus （21.3%）, Staphylococcus epidermidis （17.0%）, Klebsiella pneumoniae （10.6%）, Enterobacter cloacae （6.4%）, Escherichia coli （6.4%）, and White Rhizoctonia （4.3%）. Conclusion It is helpful to reduce the incidence of nosocomial infections and improve the prognosis of infants by analyzing the infection status related to intravascular catheter operations and the distribution of pathogens in the neonatal intensive care unit and adopting appropriate intervention measures.

关 键 词：新生儿 血管内导管相关感染 导管定植 局部感染 导管相关性血液感染 

分 类 号：R722.1[医药卫生—儿科]