NICU医院感染危险因素分析

Risk factors for nosocomial infections in neonatal intensive care units

目的探讨新生儿危重症监护病房(NICU)医院感染的危险因素。方法回顾性调查医院NICU住院患儿临床资料,分析引起医院感染的危险因素。结果医院感染发生率为12.7%;感染部位以呼吸道为主,占54.2%,其次为血液、皮肤软组织,分别占22.4%、8.4%;共培养出病原菌255株,以革兰阴性杆菌为主,占73.7%,以肺炎克雷伯菌最为多见,占14.5%,真菌占5.9%;早产儿、低出生体重儿、暖箱保暖及侵入性操作、全胃肠外营养、抗菌药物应用时间≥2周与医院感染显著相关,共有3个变量进入多元logistic回归方程:胎龄、机械通气≥3 d、抗菌药物应用时间≥2周可作为医院感染发生的独立危险因素。结论 NICU医院感染的危险因素众多,应针对危险因素采取相应的预防措施和对策。

OBJECTIVE To describe the epidemiology and risk factors for nosocomial infections（NIs） in neonatal intensive care units（NICU）.METHODS A retrospective cohort study was performed.RESULTS The incidence of NIs was 12.7%;the infection sites were respiratory tract（54.2%）,followed by blood（22.4%）,skin and soft tissues（8.4%）.Totally 255 pathogens were isolated,Gram-negative bacillus were dominant（73.7%）,of which Klebsiella pneumoniae was the most common pathogenic organisms（14.5%）;Fungal infection was 5.9%.Multivariate analysis identified seven independent risk factors for NIs： gestational age,birth weight,incubator,invasive procedures,exposure to parenteral nutrition and inadequate use of antibiotics.By multivariate logistic regression analysis,gestational age,mechanical ventilation more than 3 days and duration of antibiotics（used more than 2 weeks） were identified to be correlative with neonatal NIs independently.CONCLUSION There are many risk factors of neonatal NIs.So effective methods should be taken to decrease or control the rate of neonatal infection.