2016—2021年某妇幼保健院早产儿医院感染影响因素分析  

Influencing factors for healthcare-associated infection in premature infants in a maternal and child health hospital: 2016-2021

作　　者：付路[1] 贾伯芹 刘维韦 FU Lu;JIA Bo-qin;LIU Wei-wei(Department of Infection Management,Affiliated Maternity and Child Health Care Hospital of Nantong University,Nantong 226000,China;Department of Population Health Care,Affiliated Maternity and Child Health Care Hospital of Nantong University,Nantong 226000,China)

机构地区：[1]南通大学附属妇幼保健院感染管理科,江苏南通226000 [2]南通大学附属妇幼保健院群体保健科,江苏南通226000

出　　处：《中国感染控制杂志》2024年第3期364-369,共6页Chinese Journal of Infection Control

摘　　要：目的 了解早产儿医院感染现状及影响因素,为早产儿医院感染防控提供理论和实践依据。方法 采用回顾性研究方法,对2016年1月—2021年12月某院新生儿病房收治的早产儿进行调查分析,查阅病历,收集早产儿基本信息及住院期间诊疗信息。结果 共纳入早产儿3 559例,其中男1 964例,女1 595例;平均出生体重(2 108.66±631.17)g。发生医院感染109例,发病率3.06%;主要感染类型为下呼吸道感染(44.04%)、血流感染(28.44%)、胃肠道感染(14.68%);检出医院感染相关病原菌38株,其中革兰阴性菌33株(86.84%),革兰阳性菌3株,真菌2株。主要分离病原菌为产气肠杆菌(28.95%)、肺炎克雷伯菌(28.95%)。经单因素、非条件多因素logistic回归分析,羊水污染、出生体重<2 500 g、使用呼吸机、中心静脉插管是早产儿医院感染的独立危险因素(OR值分别为2.424、3.805、3.776、5.412,均P<0.05);剖宫产是早产儿医院感染的保护因素(OR=0.362,P<0.05)。结论 早产儿医院感染风险高,影响因素多,临床应引起重视,积极采取有循证依据的防控措施减少风险因素暴露,保护早产儿健康。Objective To understanding the current situation and influencing factors of healthcare-associated infection(HAI)in premature infants,provide theoretical and practical basis for the prevention and control of HAI in premature infants.Methods Premature infants who were admitted to the neonatal ward of a hospital from January 2016 to December 2021 were investigated and analyzed retrospectively.Medical records of premature infants were consulted to collect basic information as well as diagnosis and treatment information of premature infants during hospitalization.Results A total of 3559 premature infants were included in analysis,including 1964 males and 1595 females.The average birth weight was(2108.66±631.17)g.109(3.06%)infants had HAI infection.The main infection types were lower respiratory tract infection(44.04%),bloodstream infection(28.44%),and gastrointestinal tract infection(14.68%).38 strains of HAI-related pathogens were detected,including 33 strains(86.84%)of Gram-negative bacteria,3 strains of Gram-positive bacteria,and 2 strains of fungi.The main isolated pathogens were Enterobacter aerogenes(28.95%)and Klebsiella pneumoniae(28.95%).Univariate and unconditional multivariate logistic regression analysis showed that amniotic fluid contamination,birth weight<2500 g,ventilator use,and central venous catheterization were independent risk factors for HAI in premature infants(OR values were 2.424,3.805,3.776,5.412,respectively,all P<0.05).Cesarean section was a protective factor for HAI in premature infants(OR=0.362,P<0.05).Conclusion Premature infants have a high risk of HAI and multiple influencing factors.Clinical attention should be paid,evidence-based prevention and control measures should be actively adopted to reduce exposure to risk factors and protect the health of premature infants.

关 键 词：医院感染 影响因素 早产儿 感染防控 妇幼保健 

分 类 号：R181.32[医药卫生—流行病学]