新生儿医院感染危险因素分析

Risk factors of nosocomial infections in neonates

目的分析新生儿发生医院感染的危险因素及其病原菌分布,为防治新生儿发生医院感染提供依据。方法以2011年9月-2012年9月新生儿科住院的1483例患儿为研究对象,分析新生儿发生医院感染的危险因素及其病原菌分布。结果共有89例患儿发生医院感染,感染率为6.0%;感染部位主要为呼吸道,其次为血液系统及消化道,分别占34.8%、21.3%、14.6%;孕周<37周、出生体重<3.0kg、有侵入性操作的患儿医院感染率明显高于孕周≥37周、出生体重≥3.0kg、非侵入性操作的患儿,差异均有统计学意义(P<0.05);住院时间<7d的患儿发生医院感染的概率明显低于住院时间≥7d,差异有统计学意义(P<0.05);共分离出77株病原菌,其中革兰阴性菌45株占58.4%,革兰阳性菌28株占36.4%,真菌4株占5.2%。结论新生儿医院感染的危险因素包括孕周、出生体重、住院时间和侵入性操作等,加强新生儿的预防和护理,可有效地降低医院感染的概率。

OBJECTIVE To analyze the risk factors for nosocomial infections and the distribution of pathogenic bacteria so as to guide the prevention and control of nosocomial infections.METHODS The clinical data of 1483 neonates who were born in department of neonate from Sep.2011to Sep.2012,were investigated,and the risk factors of the nosocomial infections in the neonates and the distribution of pathogens were analyzed.RESULTS The nosocomial infections occurred in 89cases of neonates with the incidence rate of nosocomial infections of 6.0%.The respiratory tract was the predominant infection site（34.8%）,followed by the blood system（21.3%）,and the digestive tract（14.6%）.The incidence rate of nosocomial infections was significantly higher in the neonates with the pregnant period less than 37weeks,the neonates with birth weight less than 3.0kg,or the neonates who undertaken invasive operation than in the neonates with the pregnant period more than 37weeks,the neonates with birth weight more than 3.0kg,or the neonates who were undertaken invasive operation,the difference was significant（P0.05）;the incidence rate of nosocomial infections was significantly lower in the neonates with the hospitalization duration less than 7days than in the neonates with hospitalization duration more than 7days,the difference was significant（P0.05）.There were totally 77strains of pathogens isolated,including 45（58.4%） strains of gram-negative bacteria,28（36.4%）strains of gram-positive bacteria,and 4（5.2%）strains of fungi.CONCLUSIONThe risk factors of the nosocomial infections in the neonates include the pregnant period,birth weight,length of hospital stay,and invasive operation.It′s effective to decrease the infection rate of nosocomial infections through rational prevention and nursing.