新生儿病房医院感染分析与控制

Analysis of nosocomial infections of neonates and the control measures

目的了解新生儿病房医院感染发病情况及相关因素,针对易感因素进行有效控制措施。方法结合目标性监测的感染资料,再查阅医院2011年1-12月发生医院感染患儿的病历资料,进行整理分析。结果共监测住院患儿1006例,发生医院感染79例、93例次,医院感染率为7.85%、例次感染率9.24%;感染部位中以下呼吸道为首69例占74.19%,呼吸机相关性肺炎共发生8例,占下呼吸道感染的11.59%,其次血液14例占15.05%,上呼吸道5例占5.38%,胃肠和皮肤各2例占2.15%,还有其他1例占1.08%;不同体重患儿,发生感染的概率也有所不同,新生儿体重越低,发生医院感染的机会越大,体重<1000g,感染率62.50%、例次感染率75.00%,体重1001～2500g,感染率13.24%、例次感染率16.42%,体重>2500g,感染率及例次感染率均为3.39%;不同体重患儿置管相关发病率中,中心静脉置管的患儿未发生导管相关性血流感染,呼吸机相关性肺炎共发生8例,其中体重1001～2500g感染5例,感染率21.74%,体重>2500g感染3例,感染率8.11%。结论针对新生儿病房感染易发因素,采取有效措施,加强新生儿病房日常管理和监测,减少和控制新生儿医院感染。

OBJECTIVE To investigate the incidence and relative factors of the nosocomical infections in the neonatal wards and discuss the effective control measures for the predisposing factors. METHODS By means of the combi-nation of targeted monitoring data, the medical records of the neonates who got the nosocomial infections from Jan to Dec 2011 were reviewed. RESULTS Of totally 1006 cases of neonates monitored, the nosocomial infections occurred in 79 patients （93 case-times ） with the infection rate of 7. 85 % and the case-time infection rate of 9.24%. Among the various infection sites, there were 69（74.19%） cases of patients with lower respiratory tact infections, among which there were 8 （11. 59%） cases of patients with ventilator-associated pneumonia, 14 （15.05 %） cases of patients with blood infections, 5（5.38%） cases of patients with upper lower respiratory tract infections, 2 （2.15%） cases of patients with gastrointestinal tract infections or skin infections, and 1 （1.08%） case with other site infections . The neonates with different weights varied in the incidence of nosocomial infec-tions, the lower the body weight was, the higher the incidence of the nosocomial infection; the incidence of noso- comial infections in the neonates with the body weight less than 1000g was 62.50% with the case-time infection rate of 75.00% , the incidence of nosocomial infections in the neonates with the body weight varying from 1001g to 2500g was 13.24% with the case-time infection rate of 16.42%, and the incidence of nosocomial infections in the neonates with the body weight more than 2500g was 3. 29% with the case-time infection rate of 3. 29% among the incidence of the catheter-related diseases in the neonates with different body weights, there were no ca-ses of blood infections in the neonates with the indwelling central venous catheter, there were 8 cases of neonates with the ventilator-associated pneumonia , among which there were 5 （21.74 % ）cases with the body weight varying from 1001g to 2500g and 3 （8.11%） cases with the body weight more than 2500g. CONCLUSION It is necessary to strengthen the daily management and monitoring of the neonatal ward according to the predisposing factors of the noocomial infections so as to reduce and control the nosocomial infections in the neonates.