我院2013～2014年儿科新生儿医院感染的目标性监测分析

Targeted surveillance on nosocomial infections in neonates

目的探讨新生儿医院感染的特点,为有效预防医院感染提供科学依据。方法通过目标性监测对2013-04-2014-03入住儿科新生儿病房出生在28 d内的新生儿开展医院感染及其危险因素的调查与分析。结果 1 540例新生儿中,发生医院感染46例,发病率为2.99%。医院感染最常见的部位为呼吸道;单因素分析结果显示,胎龄、住院时间、出生体重、实施机械通气、气管插管、留置胃管静脉高营养治疗、输血、腰穿等因素与医院感染有关。多因素Logistic回归分析显示,出生体重≤1 000 g、住院时间〉7 d和实施机械通气是新生儿医院感染的独立危险因素。结论新生儿医院感染发病率高,极低出生体重的早产儿是重点监测对象,减少侵袭性操作,缩短住院天数,将有助于减少医院感染的发生。

Objective To explore the characteristics of nosocomial infections in neonates,and to provide a scientific basis for nosocomial infection prevention. Methods The risk factors of nosocomial infections in neonates in the neonatal intensive care unit of our hospital from April 2013 to March 2014 were studied using the targeted surveillance method. Results Of total 1 540 neonates investigated,the nosocomial infections occurred in 46 cases（ 2. 99%） among which the main infection site was respiratory tract. Univariate analysis showed that gestational age,long hospitalization duration,birth weight,mechanical ventilation,endotracheal intubation and indwelling stomach tube were associated with the nosocomial infections. Logistic regression analysis showed that birth weight,long hospitalization duration and mechanical ventilation were the risk factors that leaded to nosocomial infections in neonates.Conclusion Nosocomial infection rate is high in neonates,and the prematuve infants with low birth weight is the key target of surveillance. Reducing invasive operation and shortening the time of hospitalization days are helpful to reduce the occurrence of nosocomial infections.