新生儿病房医院感染危险因素分析

Risk factors for healthcare-associated infections in neonatal wards

目的调查新生儿病房医院感染发生情况,探讨其危险因素,为预防和控制新生儿医院感染提供科学依据。方法于2013年10月-2014年9月,采用统一的诊断标准和调查方法,对全国4个地区6所医院新生儿病房医院感染进行前瞻性监测,分析新生儿医院感染的危险因素,数据采用SPSS 18.0软件进行统计分析。结果共调查6 955例住院新生儿,其中发生医院感染73例,感染率为1.05%,住院总日数为48 040d,日感染率为1.52‰;感染部位以下呼吸道居多占22.08%;病原菌以革兰阴性菌为主占73.91%;多因素分析显示,新生儿母亲产前有感染性疾病或有重度先兆子痫,使用胃管,出生后10min Apgar评分≤7分和胎龄<36周,是医院感染的独立危险因素。结论应针对医院感染危险因素制定相应的预防措施,降低医院感染的发生。

OBJECTIVE To investigate the incidence of healthcare-associated infections in neonatal wards and explore the risk factors so as to provide scientific basis for prevention and control of healthcare-associated infections in neonates.METHODS From Oct 2013 to Sep 2014,the prospective monitoring was carried out for the healthcareassociated infections in the neonatal wards of 6hospitals in 4areas of China by means of unified diagnostic criteria and investigation methods,the risk factors for the healthcare-associated infections in the neonates were analyzed,and the statistical analysis of data was performed with the use of SPSS 18.0software.RESULTS Of 6 955 hospitalized neonates who were enrolled in the study,73 had the healthcare-associated infections,with the infection rate of1.05%;the total length of hospital stay was 48 040 days,and the daily intation rate was 1.52‰.The neonates with lower respiratory tract infections accounted for 22.08%.The gram-negative bacteria were dominant among the pathogens,accounting for 73.91%.The multivariate analysis indicated that the independent risk factors for the healthcare-associated infections included the prenatal infectious diseases or preeclampsia in the mothers,use of gastric tube,Apgar score no more than 7points after delivery for 10 min,and gestational age less than 36 weeks.CONCLUSIONS It is necessary to formulate corresponding prevention measures aiming at the risk factors for the healthcare-associated infections so as to reduce the incidence of the healthcare-associated infections.