新生儿重症监护病房感染病原菌分布、药敏分析及相关危险因素回归分析  

The distribution,drug susceptibility of pathogenic bacteria infections in neonatal intensive care unit and regression analysis for the related risk factors

作　　者：张亮[1] 谢芳[1] ZHANG Liang;XIE Fang(Department of Pediatrics,Shiyan City Hospital for Maternal and Child Health,Hubei,Shiyan 442000,China)

机构地区：[1]湖北省十堰市妇幼保健院儿科,442000

出　　处：《河北医药》2018年第5期775-777,共3页Hebei Medical Journal

基　　金：湖北省自然科学基金资助项目(编号:2015FFB04310)

摘　　要：目的探讨新生儿重症监护病房(NICU)感染病原菌分布、药敏情况及相关危险因素。方法回顾性分析收入NICU治疗的107例患儿,出现多重耐药菌感染27例,出现非多重耐药菌感染患儿80例,对新生儿重症监护病房感染病原菌分布、药敏情况及凶猛的多重耐药菌感染相关危险因素进行分析。结果新生儿NICU感染病原菌的部位中,上呼吸道、下呼吸道、泌尿道、消化道、血流、皮肤及其他部位感染比例分别为25.2%、21.5%、13.1%、15.0%、8.4%、9.3%、7.5%;107例患儿身上共分离出115株病原菌,其中革兰阳性球菌69株(60.0%),革兰阴性杆菌46株(40.0%);大肠埃希菌与肺炎克雷伯菌共45株,占革兰阴性菌总株数的65.2%(45/69),凝固酶阴性葡萄球菌与金黄色葡萄球菌共31株,占革兰阴性菌总株数的67.4%(31/46);单因素Logistic回归分析显示,患儿的出生体重、联合使用抗菌药物及抗菌药物使用时间是NICU感染患儿多重耐药菌感染的独立危险因素(P<0.05)。结论新生儿多重耐药菌感染时病情较为凶险,应针对联合使用抗菌药物及抗菌药物使用时间等危险因素严格掌控,减少新生儿NICU多重耐药菌感染风险。Objective To investigate the distribution and drug susceptibility of pathogenic bacteria infections in neonatal intensive care unit(NICU)and related risk factors.Methods The clinical data about 107 infant patients who were admitted and treated in NICU of our hospital from January 2013 to January 2017 were retrospectively analyzed,including 27 cases of multiple drug-resistant bacteria infection and 80 cases of non-multiple drug-resistant bacteria infection.The distribution and drug susceptibility of pathogenic bacteria infections as well as related risk factors with pathogenic bacteria infections were analyzed by Logistic regression method.Results In the aspect of pathogenic bacteria infections position of neonates in NICU,the infection rates in upper respiratory tract,lower respiratory tract,urinary tract,digestive tract,blood,skin and other parts were 25.2%,21.5%,13.1%,15.0%,8.4%,9.3%,8.4%,respectively,and 115 strains of pathogenic bacteria were isolated from 107 patients,in which,there were 69 strains(60.0%)of gram-positive coccus,46 strains(40.0%)of gram-negative bacillus.Moreover there were 45 strains of E.coli and klebsiella pneumonia bacteria,which accounted for 65.2%(45/69)of the total number of gram-negative bacteria,and 31 strains of coagulase-negative staphylococcus aureus and staphylococcus aureus,which accounted for 67.4%(31/46)of the total number of gram-negative bacteria.The single factor Logistic regression analysis showed that the neonate’s birth weight,combined use of antimicrobial agents and use time of antimicrobial drugs were the independent risk factors which resulted in drug-resistant bacteria infection.Conclusion The disease condition of neonates with multiple drug-resistant bacteria infection is relatively dangerous,therefor,it is necessary to combine to use antimicrobial agents and control the use time of antimicrobial drugs so as to reduce the risk of multiple drug-resistant bacteria infection of neonates in NICU.

关 键 词：新生儿重症监护室 病原菌 感染 危险因素 

分 类 号：R195[医药卫生—卫生统计学]