新生儿重症监护病房院内感染细菌学变迁及易感因素分析

发布时间：2019-04-17 12:25

【摘要】：目的探讨新生儿重症监护病房(NICU)院内感染病原菌变迁及感染危险因素。方法回顾性分析2010年1月至2015年12月NICU中5 543例新生儿的临床资料。结果研究期间院内感染率8.75%。院内感染病原菌以表皮葡萄球菌最多,其次为大肠埃希菌及肺炎克雷伯菌。呼吸系统感染占37.73%,血液系统占37.53%。阳性标本中,血液标本所占比例最高36.47%,痰液占32.67%。前三年院内感染病原菌以白假丝酵母菌、肺炎克雷伯菌、表皮葡萄球菌为主;后三年病原菌以表皮葡萄球菌、大肠埃希菌、肺炎克雷伯菌肺炎亚种感染最多。出生胎龄37周(OR=2.29,95%CI:1.89~2.77)、出生体质量1 500 g(OR=37.91,95%CI:29.85~48.16)、机械通气(OR=23.16,95%CI:5.72~71.31)、男性(OR=1.24,95%CI:1.03~1.49)、留置尿管(OR=3.73,95%CI:1.94~19.36)为NICU院内感染危险因素。结论新生儿院内感染主要以呼吸及血行感染多见,以表皮葡萄球菌、大肠埃希菌、肺炎克雷伯菌感染多见。早产、极低出生体质量儿、机械通气、男性、留置尿管是主要危险因素。
[Abstract]:Objective to investigate the changes of pathogenic bacteria and risk factors of nosocomial infection in neonatal intensive care unit (NICU). Methods the clinical data of 5 543 neonates with NICU from January 2010 to December 2015 were retrospectively analyzed. Results the nosocomial infection rate was 8.75%. Staphylococcus epidermidis was the most pathogenic bacteria in nosocomial infection, followed by Escherichia coli and Klebsiella pneumoniae. Respiratory system infection accounted for 37.73%, blood system accounted for 37.53%. Among the positive samples, the highest percentage was 36.47% in blood samples and 32.67% in sputum. In the first three years, Candida albicans, Klebsiella pneumoniae and Staphylococcus epidermidis were the main pathogens, while Staphylococcus epidermidis, Escherichia coli and Klebsiella pneumoniae were the most common pathogens in the last three years. Birth age 37 weeks (OR=2.29,95%CI:1.89~2.77), birth weight 1,500 g (OR=37.91,95%CI:29.85~48.16), mechanical ventilation (OR=23.16,95%CI:5.72~71.31), male (OR=1.24,95%CI:1.03~1.49), Indwelling catheter (OR=3.73,95%CI:1.94~19.36) was a risk factor for nosocomial infection of NICU. Conclusion Neonatal nosocomial infection is mainly caused by respiratory and hematological infection, Staphylococcus epidermidis, Escherichia coli and Klebsiella pneumoniae. Premature birth, very low birth weight infants, mechanical ventilation, male, indwelling catheter are the main risk factors.
【作者单位】：内蒙古包头市包钢集团第三职工医院新生儿科;
【分类号】：R446.5;R722.13

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