中国大陆地区新生儿院内感染病原体分布的系统评价

Distribution of the nosocomial infection pathogens among neonates in China:systematic review

目的采用循证分析的方法系统评价我国大陆地区新生儿院内感染病原体分布情况,为临床控制新生儿医院感染提供更好的科学依据。方法全面系统检索中国知网（CNKI）、中国生物医学文献服务系统（CBM）、维普（VIP）、万方数据库（WanFang）及PubMed。对文献进行筛选,使用Excel软件提取数据,运用Comprehensive Meta Analysis软件进行率的合并计算,根据异质性检验结果选择合适模型。结果研究共纳入68篇合格文献,新生儿院内感染最常见病原体为葡萄球菌属[32%（95%CI：27%-37%）]、沙门菌属[32%（95%CI：0%-68%）]。亚组分析显示：三级和二级及以下等级医院新生儿院内感染最常见病原体均为葡萄球菌;专科医院最常见病原体为葡萄球菌属,综合性医院最常见病原体为沙门菌属;东部地区医院最常见病原体为沙门菌属,中部和西部地区医院最常见病原体均为葡萄球菌属;1985-1999年最常见病原体为葡萄球菌属,2000-2012年最常见病原体为病毒。结论新生儿院内感染最常见病原体为葡萄球菌属。

Objective To provide better clinical management, we use evidence-based analysis through systematic evaluation the distribution of pathogens of neonatal nosocomial infections in China. Methods We searched from CNKI, CBM, VIP,Wanfang and PubMed. The articles were selected according the criteria,and the qualified articles were extracted related data using excel soft- ware. The related rate were calculated and merged by using Comprehensive Meta Analysis software and selected appropriate model calculation OR value and 95 % confidence interval. Results Sixty-eight articles were included. The most common pathogens of neo natal nosocomial infection were Staphylococcus[32 %（95% CI： 27% - 37%）], Salmonella[32%（95% CI： 0% - 68%）; in China. Subgroup analysis revealed ： the most common pathogen of infection were Staphylococcus in the hospitals at all levels ; the most com- mon pathogen of infection was Staphylococcus in the special hospital,while Salmonella in the general hospital; the most common pathogen of infection was Salmonella in the eastern region, and were Staphylococcus in the central and western region. The most common pathogen of infection was Staphylococcus from 1985 to 1999,and was Virus from 2000 to 2012. Conclusion Staphylococ- cus was the most common pathogen.