2012—2015年重症儿童中心静脉导管相关血流感染前瞻性研究

发布时间：2018-03-20 15:05

本文选题：中心静脉导管相关血流感染　切入点：重症监护病房　出处：《中国感染控制杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的了解重症儿童中心静脉导管相关血流感染(CLABSI)发病情况,为制定防控措施提供依据。方法采用前瞻性目标监测方法,监测2012年1月—2015年12月7个儿童及新生儿重症监护病房(ICU)中心静脉置管患者CLABSI情况。结果共有37 712例患者住院,总住院日为268 531 d,中心静脉置管日数为57 639 d,中心静脉导管使用率为21.46%;126例患者发生CLABSI,CLABSI发病率为2.19/1 000插管日,各年度CLABSI发病率比较,差异无统计学意义(P0.05);第三季度CLABSI发病率高于其他季度[均P0.05,其中与第1季度比较,RR(95%CI)=1.98(1.20,3.29)];不同类型ICU的CLABSI发病率不同,新生儿外科ICU(SNICU)发病率(6.12/1 000插管日)高于其他类型ICU[均P0.05,其中与儿童ICU比较,RR(95%CI)=3.02(1.51~6.04)]。126例CLABSI患者共分离病原菌139株,主要病原菌为肺炎克雷伯菌(20.86%)和表皮葡萄球菌(15.83%)。结论外科重症新生儿是CLABSI感染的高危人群,应针对该科室制定强化措施进行干预,才能有效降低CLABSI。
[Abstract]:Objective to investigate the incidence of CLABSIin the central venous catheter associated blood flow infection in severe children, and to provide the basis for the prevention and control measures. From January 2012 to December 2015, the CLABSI of 7 patients with central venous catheterization in children and neonatal intensive care unit (NICU) were monitored. Results A total of 37 712 patients were hospitalized. The total hospitalization days were 268,531 days, the number of central venous catheterization days was 57,639 days, the utilization rate of central venous catheters was 21.46 and the incidence of CLABSICLABSI was 2.19 / 1 000 intubation days. The incidence of CLABSI in each year was compared. The incidence of CLABSI in the third quarter was higher than that in the other quarters (P0.05, respectively, compared with the first quarter). The incidence of CLABSI in different types of ICU was different. The incidence of ICU in neonatal surgery was 6.12 / 1 000 intubation days), which was higher than that of other types of ICU (all P 0.05, including 3.02% 1.51% 6.04 in comparison with ICU in children). 139 strains of pathogenic bacteria were isolated from 126 patients with CLABSI. The main pathogenic bacteria were Klebsiella pneumoniae 20.86) and Staphylococcus epidermidis 15.83.Conclusion the severe surgical newborns are the high risk population of CLABSI infection.
【作者单位】：广州市妇女儿童医疗中心;
【基金】：广东省科技计划项目(2012B061700011) 广州市科技计划项目(2014Y2-00031)
【分类号】：R473.72

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