新生儿重症监护室医院感染病原菌特点与危险因素分析

发布时间：2018-11-18 11:52

【摘要】：目的：探讨新生儿重症监护病房院内感染常见病原菌的分布及进行危险因素分析，对临床治疗提供理论依据。方法：对我院NICU3726例新生儿进行统计，建立对照组进行Logistic回归分析得出危险因素。结果：1)感染现状：我院新生儿医院内感染的发生率为7.7%，呼吸机相关性感染率为80.4/1000机械通气-天，，胎龄、出生体重与呼吸机相关性感染率无统计学意义。2)感染部位：肺部、口腔、血行感染分别占总感染例次的56.7%、8.1%及11.3%。泌尿系统感染及皮肤粘膜感染也占一定比例。3)医院感染病原菌分布为：G+菌占分离菌株37.6%；G-菌占分离菌株60.3%。4)危险因素：出生体重≤1500g、胎龄≤32周、小于胎龄儿、新生儿窒息、肠外营养、机械通气等为医院感染相关危险因素(P＜0.001)；其中肠外营养，出生体重≤1500g，机械通气为主要危险因素(OR值分别为：8.135，3.142，2.377)。结论：1)我院新生儿医院感染发生率偏低，主要为肺部感染。2)新生儿院内感染以革兰氏阴性菌为主，常见菌为肺炎克雷伯菌及大肠杆菌。革兰氏阳性菌感染以草绿色链球菌及金黄色葡萄球菌多见。3)出生体重≤1500g、小于胎龄儿、出生合并窒息史、胎龄≤32周，肠外营养、机械通气为医院感染相关危险因素。出生体重≤1500g，肠外营养，机械通气为我院NICU医院感染的主要危险因素。4)预防措施：严格手卫生，掌握机械通气指征，执行无菌操作，合理安排清理呼吸道频率，避免反复插管，缩短机械通气时间，加强早期微量喂养等可起到预防医院感染的作用。
[Abstract]:Objective: to investigate the distribution and risk factors of common pathogens of nosocomial infection in neonatal intensive care unit (NICU) and to provide theoretical basis for clinical treatment. Methods: the risk factors of NICU3726 neonates were analyzed by Logistic regression analysis. Results: 1) infection status: the incidence of nosocomial infection of neonates in our hospital was 7.7, and the ventilator-associated infection rate was 80.41000% mechanical ventilation days, gestational age. There was no significant difference between birth weight and ventilator-associated infection rate. 2) infection sites: lung, oral cavity and blood accounted for 56.1% and 11.3% of the total infection respectively. Urinary tract infection and skin and mucous membrane infection also accounted for a certain proportion. 3) the distribution of nosocomial infection pathogenic bacteria was: G bacteria accounted for the isolated strain 37.6; The risk factors of nosocomial infection were: birth weight 鈮

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