NICU 早产儿医院感染回顾性调查分析

Retrospective survey of nosocomial infections in preterm infants of NICU

目的调查分析新生儿重症监护病房(NICU)早产儿医院感染及其相关因素,为NICU早产儿医院感染的预防和控制提供参考依据。方法回顾性分析2012年2月-2013年10月186例NICU早产儿医院感染的临床资料,对引发NICU早产儿医院感染的相关因素进行分析;采用SPSS10.0软件对数据进行统计分析。结果 186例早产患儿发生医院感染28例,感染率为15.05%;医院感染时间(15.5±10.8)d;早产儿医院感染部位以呼吸道、皮肤组织、胃肠道、泌尿道为主,分别占39.29%、21.43%、14.29%、10.71%;从血液、粪便和分泌物等标本中分离出病原菌28株,其中革兰阴性菌15株占53.58%、革兰阳性菌10株占35.71%、真菌3株占10.71%;早产儿体质量、胎龄、实施侵入性操作、住院时间、抗菌药物使用时间、肾上腺糖皮质激素使用等与早产儿医院感染的发生具有相关性(P<0.05)。结论早产儿医院感染以呼吸道感染、革兰阴性菌感染为主,低体质量、胎龄小、实施侵入性操作、住院时间长、抗菌药物使用、肾上腺糖皮质激素使用是早产儿发生医院感染的影响因素。

OBJECTIVE To investigate the related factors for nosocomial infections in the preterm infants of neo‐natal intensive care unit （NICU） so as to provide guidance for prevention and control of the nosocomial infections in the preterm infants of NICU .METHODS The clinical data of 186 preterm infants with nosocomial infections who were treated in the NICU from Feb 2012 to Oct 2013 were retrospectively analyzed ,the related factors for the nos‐ocomial infections in the preterm infants were analyzed ,and the statistical analysis was performed with the use of SPSS10 .0 software .RESULTS The nosocomial infections occurred in 28 of 186 preterm infants ,with the infection rate of 15 .05% ;the time of the nosocomial infections was （15 .5 ＆#177; 10 .8）d .Of the preterm infants with nosocomial infections ,39 .29% had the respiratory tract infections ,21 .43% had the skin and soft tissue infections ,14 .29%had the gastrointestinal tract infections ,and 10 .71% had the urinary tract infections .A total of 28 strains of pathogens have been isolated from the blood ,stools ,and secretions specimens ,including 15 （53 .58% ） strains of gram‐negative bacteria ,10 （35 .71% ） strains of gram‐positive bacteria ,and 3 （10 .71% ） strains of fungi .The in‐cidence of the nosocomial infections in the preterm infants was associated with the body mass index ,gestational age ,invasive operation ,length of hospital stay ,time of use of antibiotics ,and use of glucocorticoids （P〈0 .05） . CONCLUSION The preterm infants with respiratory tract infections are dominant among the preterm infants with nosocomial infections which are mainly caused by the gram‐negative bacteria .The influencing factors for the noso‐comial infections in the preterm infants include the low body mass index ,short gestational age ,invasive operation , long length of hospital stay ,use of antibiotics ,and use of glucocorticoids .