医院新生儿重症监护病房患儿多重耐药菌定植特征及危险因素分析  

Analysis of Colonization Characteristics and Risk Factors of Multidrug-resistant Bacteria in Children in Neonatal Intensive Care Unit of Hospital

作　　者：沈诗华 王家亮 郭德莹[1] 李敏[2] 曹海燕[2] 韩丽娟 胡洁 刘文佳 孟凡祥 朱振华[1] SHEN Shihua;WANG Jialiang;GUO Deying;LI Min;CAO Haiyan;HAN Lijuan;HU Jie;LIU Wenjia;MENG Fanxiang;ZHU Zhenhua(Infection Management Department of Fuyang People's Hospital,Fuyang,Anhui,236000,China;不详)

机构地区：[1]阜阳市人民医院医院感染管理科,安徽阜阳236000 [2]阜阳市人民医院新生儿重症监护病房,安徽阜阳236000

出　　处：《中国社会医学杂志》2025年第2期260-263,共4页Chinese Journal of Social Medicine

基　　金：阜阳市卫生健康委科研立项课题(FY2019-046、FY2021-023、FY2021-140)。

摘　　要：目的通过对某三甲院新生儿重症监护病房中患儿多重耐药菌(multidrug-resistant organism,MDRO)定植状况进行调查分析,为制定MDRO防控措施提供科学的依据。方法选择安徽省某三甲医院新生儿重症监护病房2019年10月-2021年10月期间入院的48 h新生儿4331例,根据纳入标准和美国临床实验室标准化研究所2019标准判定多重耐药菌定植患儿,对患儿多重耐药菌定植的分布特征及危险因素进行分析。结果纳入的4331例新生儿中,患儿定植菌检出率为8.59%,其中多重耐药菌定植检出率为11.02%。定植部位以肛拭子占比(41.46%)为主。Logisitic回归分析显示,体质量<2500 g(OR=31.844,P=0.009)、体质量2500~<4000 g(OR=8.018,P=0.015)、住院天数<7 d(OR=8.206,P<0.001)、住院天数7~14 d(OR=4.328,P=0.002)、使用呼吸机(OR=3.698,P=0.025)、中心静脉插管(OR=3.887,P=0.022)是新生儿重症监护病房MDRO定植的独立危险因素。结论新生儿定植菌筛查可实现早期发现潜在感染者,进而将新生儿的预防和治疗措施前移,从而降低新生儿定植菌引起感染的发生和扩散。Objective To investigate and analyze the colonization status of multidrug-resistant organism(MDRO)in children in the neonatal intensive care unit of a hospital,and to provide a scientific basis for the formulation of MDRO prevention and control measures.Methods A total of 433148-hour neonates admitted to the neonatal intensive care unit of A third hospital in Anhui province from October 2019 to October 2021 were selected,and the colonization characteristics and risk factors of multidrug-resistant bacteria colonization were determined according to the inclusion criteria and the 2019 criteria of the Clinical Laboratory Standards Institute(CLSI),and the distribution characteristics and risk factors of multidrug-resistant bacterial colonization were analyzed.Results Among the 4331 neonates enrolled,the detection rate of colonizing bacteria was 8.59%,and the detection rate of colonization of multidrug-resistant bacteria was 11.02%.Swabs accounted for 41.46%of the colonization sites.Logistic regression ana-lysis showed that body weight<2500 g(OR=31.844,P=0.009),weight 2500-<4000 g(OR=8.018,P=0.015),hospitalization days<7 days(OR=8.206,P<0.001),hospitalization days 7-≤14 days(OR=4.328,P=0.002),use of ventilator(OR=3.698,P=0.025),central venous cannula(OR=3.887,P=0.022)were independent risk factors for MDRO colonization in neonatal intensive care units.Conclusion Neonatal colonizing bacteria screening can rea-lize the early detection of potential infections,and then move forward the prevention and treatment measures of neonates,thereby reducing the occurrence and spread of infection caused by neonatal colonizing bacteria.

关 键 词：新生儿 重症监护病房 多重耐药菌 定植 主动筛查 

分 类 号：R722.13[医药卫生—儿科]