新生儿医院感染目标性监测分析和防控策略

Analysis of Objective Surveillance and Prevention and Control strategies for Nosocomial Infection in Neonates

目的:了解新生儿医院感染现状、危险因素,探讨医院感染预防和控制策略。方法:按照《医院感染监测规范》开展新生儿目标性监测,对医院2014年1月1日至2016年12月31日所有住院新生儿进行监测,对监测结果进行汇总分析,并对防控策略进行总结。结果:共监测住院新生儿6 161例,发生医院感染60例,感染率为0.97%,例次感染率为1.07%。医院感染部位中,败血症占首位,其次为新生儿感染,第三为胃肠道感染。新生儿日感染率1.4‰,其中超低出生体重儿(≤1 000 g)日感染率最高,为11.5‰;正常出生体重儿(>2 500 g)最低,为0.6‰。体重越低的新生儿,医院感染风险越高。不同体重新生儿呼吸机使用率、中心静脉导管使用率比较,差异显著,有统计学意义。不同体重新生儿呼吸机相关性肺炎和中心静脉导管相关感染发病率无统计学差异。结论:低体重早产儿是医院感染控制重点,应开展新生儿目标性监测,严格无菌操作和手卫生,保证环境清洁无污染,有效预防新生儿医院感染的发生。

Objective： To understand the present situation and risk factors of nosocomial infection in neonates, and to explore the prevention and control strategies of nosocomial infections. Methods：According to the Standard for Nosocomial Infection Surveillance, all hospitalized newborns were monitored from January 1,2014 to December 31,2016. The monitoring results are collected and ana- lyzed, and the prevention and control strategies are summarized. Results ：A total of 6,161 neonates were monitored. Among all the neo- nates, 60 cases of neonates nosocomial infection occurred. The infection rate is 0.97%, the case-time infection rate is 1.07%. Among nosocomial infection sites, septicemia takes the first place, followed by neonatal infection, and the third is gastrointestinal tract infec- tion. The daily infection rate of neonates is 1.4‰. Among them, the infection rate of ultra-low birth weight infants （≤1 000 g）was the highest, and that of normal birth weight infants（ 〉2 500 g）was the lowest（0.6‰）. The lower the birth weight, the higher the risk of noso- comial infection. The utilization rate of ventilator and central venous catheter in newborns with different weights are significantly differ- ent. The difference is statistically significant. There was no significant difference in the incidence of ventilator-associated pneumonia and central venous catheter-related infection in neonates with different weights. Conclusion： Low birth weight premature infants are the key points of nosocomial infection control. It is necessalT to carry out targeted neonatal surveillance and strict aseptic operation and hand hygiene, as well as ensure clean and pollution-free environment so as to effectively prevent neonatal nosocomial infection.