新生儿医院感染病原菌分布特点及危险因素分析  

Analysis on the pathogen distribution characteristics and risk factors of neonatal nosocomial infection

作　　者：王涛 刘卫平 漆丽 毛欣宇 WANG Tao;LIU Wei-ping;QI Li;MAO Xin-yu(Inner Mongolia Medical University,Hohhot Inner Mongolia010010,China;Inner Mongolia People’s Hospital)

机构地区：[1]内蒙古医科大学,内蒙古呼和浩特010010 [2]内蒙古自治区人民医院

出　　处：《中国消毒学杂志》2024年第6期429-432,共4页Chinese Journal of Disinfection

基　　金：内蒙古自治区自然科学基金面上项目(2022MS08083);内蒙古自治区科技计划项目(2022YFSH0135);内蒙古自治区卫生健康科技计划(202201024);内蒙古自治区人民医院院内基金(2021YN03)。

摘　　要：目的探讨新生儿科医院感染的病原菌分布及危险因素。方法采用回顾性调查方法,以2021年1月—2022年12月某医院新生儿病房1569例新生儿为调查对象。收集住院临床病历资料和血液、痰液、脐部分泌物等标本病原菌分离和鉴定结果,应用单因素和多因素logistic回归分析法查找新生儿医院感染的危险因素。结果医院感染发生率为4.91%,以呼吸道为主(50.65%),其次为泌尿道感染。77例医院感染患儿中共检出85株病原菌,以革兰阴性菌为主(60.2%),其中大肠埃希菌占比最高(47.05%);革兰阳性菌中溶血葡萄球菌占比最高(9.41%)。多因素logistic回归分析显示胎龄<37周、基础疾病≥3种、住院时间≥7 d、羊水污染、机械通气和喂养不耐受是新生儿医院感染的独立危险因素。结论新生儿院内感染以呼吸道感染为主,病原菌以革兰阴性菌较为常见,应针对高危因素采取有效防控措施,降低医院感染发生率。Objective To explore the distribution of pathogens and risk factors of neonatal hospital infections.Methods A retrospective survey was conducted on 1569 newborns in the neonatal ward of a certain hospital from January 2021 to December 2022.Hospital clinical medical records and pathogen isolation and identification results of blood,sputum and umbilical secretions were collected,and the univariate analysis and multivariate logistic regression analysis were used to identify the risk factors for nosocomial infection in newborns.Results The incidence rate of nosocomial infection was 4.91%,mainly respiratory tract(50.65%),followed by urinary tract infection.A total of 85 pathogenic strains were detected in 77 children with nosocomial infection,mainly Gram-negative bacteria(60.2%),among which Escherichia coli had the highest proportion(47.05%).The proportion of Staphylococcus hemolyticus in Gram positive bacteria was the highest(9.41%).Multivariate logistic regression analysis showed that gestational age<37 weeks,having three or more underlying diseases,hospital stay of≥7 d,amniotic fluid contamination,mechanical ventilation,feeding intolerance,mechanical ventilation and feeding intolerance were independent risk factors for neonatal nosocomial infection.Conclusions Neonatal nosocomial infection is mainly respiratory tract infection,and pathogenic bacteria are common with Gram-negative bacteria.Effective prevention and control measures should be taken especially for high risk factors to reduce the nosocomial infection rate.

关 键 词：新生儿 医院感染 危险因素 病原菌 

分 类 号：R378[医药卫生—病原生物学]