新生儿室医院感染调查分析

Prevalence of nosocomial infections in neonatal rooms

目的探讨新生儿监护室医院感染的发生率及感染病原菌分布情况,以期能为更好地控制新生儿医院感染的发生提供一定参考。方法回顾性分析医院2012年1-6月在新生儿监护室收治的770例新生儿临床资料,统计分析医院感染及病原菌培养结果、感染危险因素等。结果发生医院感染新生儿39例,感染率5.06%;感染部位分布为呼吸系统21例、血液系统6例、皮肤4例、泌尿系统2例、其他部位6例,各占53.85%、15.38%、10.26%、5.13%、15.38%;医院感染新生儿在血液、分泌物、粪便、导管头中共培养出29株病原菌,其中大肠埃希菌17株,鲍氏不动杆菌5株,无乳链球菌3株,肺炎克雷伯菌2株,铜绿假单胞菌及金黄色葡萄球菌各1株,分别占58.62%、17.24%、10.35%、6.90%、3.45%、3.45%;不同胎龄、出生体重、住院时间、有无侵入性操作及预防使用抗菌药物等因素之间感染率明显存在不同,差异有统计学意义(P<0.05)。结论新生儿是医院感染的高发对象,呼吸系统是感染最常见部位,大肠埃希菌是最常见感染病原菌,应针对导致新生儿医院感染的胎龄、出生体重、住院时间、侵入性操作、预防使用抗菌药物等高危因素采取必要的预防控制措施,以降低新生儿医院感染发生率。

OBJECTIVE To explore the incidence of nosocomial infections in the neonatal unit and the distribution of pathogens causing the infections so as to provide basis for the control of nosocomial infections in the neonates.METHODS The medical records of 770 cases of neonates who were treated in the neonatal unit from Jan to Jun 2012 were retrospectively analyzed,the incidence of nosocomial infections,the results of bacterial culture,and the risk factors of infections were statistically analyzed.RESULTS The nosocomial infections occurred in 39 cases of neonates with the infection rate of 5.06%,among which there were 21（53.85%） cases with respiratory tract infections,6（15.38%） cases with blood infections,4（10.26%） cases with skin infections,2（5.13%） cases with urinary tract infections,and 6（15.38%） cases with other site infections.A total of 29 strains of pathogens were isolated from the neonatal blood,secretion,excrement and urine,and catheter head,including 17（58.62%） strains of Escherichia coli,5（17.24%） strains of Acinetobacter baumannii,3（10.35%） strains of Streptococcus agalactiae,2（6.90%） strains of Klebsiella pneumoniae,1（3.45%） strain of Pseudomonas aeruginosa,and 1（3.45%） strain of Staphylococcus aureus.There was significant difference in the infection rate among the gestational age,birth weight,length of hospital stay,invasive operation and preventive use of antibiotics,the difference was statistically significant（P0.05）.CONCLUSION The neonates are the population at high risk of the nosocomial infections,the respiratory tract is the prevalent infection site,E.coli is the most common species of pathogens causing the infections.It is necessary to take appropriate prevention and control measures by aiming at the high risk factors such as the gestational age,birth weight,length of hospital stay,invasive operation and preventive use of antibiotics so as to reduce the incidence of nosocomial infections in the neonates.