新生儿重症监护病房医院感染与病原菌谱:一项单中心五年研究  

Healthcare-associated infection and pathogen spectrum in neonatal intensive care unit: a 5-year single-center study

作　　者：李艳敏 张瑞敏[2] 平莉莉[2] 翟丽娜 张晓丽 韩军月 LI Yan-min;ZHANG Rui-min;PING Li-li;ZHAI Li-na;ZHANG Xiao-li;HAN Jun-yue(Graduate School of Hebei North University,Zhangjiakou 075000,China;Neonatal Department,Handan Central Hospital,Handan 056000,China)

机构地区：[1]河北北方学院研究生学院,河北张家口075000 [2]邯郸市中心医院新生儿科,河北邯郸056000

出　　处：《中国感染控制杂志》2024年第2期195-200,共6页Chinese Journal of Infection Control

基　　金：河北省卫健委重点科技研究计划项目(20220521)。

摘　　要：目的 了解新生儿重症监护病房(NICU)医院感染病原菌谱及变迁情况。方法 收集2018年1月—2022年12月某院NICU发生医院感染新生儿的临床病历资料,回顾性分析医院感染的病原菌谱情况。结果 共调查7 597例住院新生儿,240例发生医院感染,共263例次,医院感染发病率为3.16%,例次发病率为3.46%。其中血流感染96例(36.50%),呼吸系统感染70例(26.62%),感染部位不明确者57例(21.67%)。送检标本中共检出病原菌170株,其中革兰阳性菌78株(45.88%),以葡萄球菌属占比最高;革兰阴性菌78株(45.88%),以肺炎克雷伯菌为主;真菌14株(8.24%)。2018—2022年革兰阴性菌检出比率呈上升趋势(P<0.01)。结论 NICU医院感染以血流感染居多。近几年革兰阴性菌检出率逐年上升,临床应加强医院感染的预防与控制。Objective To understand the spectrum and changes of pathogens causing healthcare-associated infection(HAI)in neonatal intensive care unit(NICU).Methods Clinical medical records of neonates with HAI in a hospital from January 2018 to December 2022 were collected,spectrum of pathogens causing HAI were and analyzed retrospectively.Results A total of 7597 hospitalized neonates were investigated,and 240 of whom had 263 cases of HAI,with an HAI incidence of 3.16%and healthcare-associated case infection incidence of 3.46%.96 cases(36.50%)were bloodstream infection,70(26.62%)were respiratory system infection,and 57(21.67%)were infection without clear sites.A total of 170 pathogens were detected from specimens,78(45.88%)of which were Gram-positive bacteria,with Staphylococcus spp.accounting for the highest proportion,78(45.88%)were Gram-negative bacteria,mainly Klebsiella pneumoniae,and 14(8.24%)were fungi.The detection rate of Gram-negative bacteria showed an upward trend from 2018 to 2022(P<0.01).Conclusion The majority of HAI in NICU is bloodstream infection.In recent years,the detection rate of Gram-negative bacteria has been increasing year by year,and it is necessary to streng-then the prevention and control of HAI in clinical practice.

关 键 词：新生儿 新生儿重症监护病房 医院感染 病原菌 

分 类 号：R181.32[医药卫生—流行病学]