我院2010—2017年新生儿无乳链球菌医院感染的流行病学调查分析

Epidemiological investigation and analysis of nosocomial infections of neonatal Streptococcus agalactiae in our hospital from 2010 to 2017

目的分析新乡市中心医院8年间新生儿感染无乳链球菌的流行病学特征。方法采取描述性流行病学方法对近8年间我院接收的16379例新生儿临床资料进行回顾性分析,比较不同时间、人口学特征下无乳链球菌感染率差异,并分析分离菌株耐药性特征。结果2010—2017年新乡市中心医院累计接收新生儿16379例,其中确诊感染无乳链球菌新生儿病例数为61例,年均感染率为3.72‰,随年份增加感染率有缓慢下降趋势,不同年份间比较无统计学意义(P>0.05);第2、第3季度新生儿无乳链球菌感染率相对较高,但各季度间感染率比较无统计学意义(P>0.05);男性新生儿无乳链球菌感染率略高于女性,二者间比较无统计学意义(P>0.05);32周~胎龄段新生儿无乳链球菌感染率较高,不同胎龄段间比较有统计学意义(P<0.05);1.5kg~出生体重段新生儿无乳链球菌感染率较高,不同出生体重间比较有统计学意义(P<0.05);阴道分娩新生儿无乳链球菌感染率明显高于剖宫产新生儿,二者差异有统计学意义(P<0.05);0分~的1min Apgar评分段新生儿无乳链球菌感染率较高,4分~的评分段次之,不同1min Apgar评分间比较有统计学意义(P<0.05)。无乳链球菌药敏试验结果显示,菌株对头孢噻肟、美罗培南、利奈唑胺、万古霉素、青霉素、氨苄西林等完全敏感,对红霉素和克林霉素耐药率较高,分别为73.77%和72.13%。结论我院发现早产、低出生体重、经阴道分娩及缺氧体征因素的新生儿感染风险较大,产科临床针对无乳链球菌感控防治工作可根据其耐药性特征加以干预。

Objective To analyze the epidemiological characteristics of neonatal infections of Streptococcus agalactiae in Xinxiang Central Hospital during seven years. Methods Descriptive epidemiological methods were used to retrospectively analyze the clinical data of 16,379 neonates received in our hospital in the past eight years. The differences in the infection rates of Streptococcus agalactiae under different time and demographic characteristics were compared and the drug resistance features of isolated strains were analyzed. Results From 2010 to 2017, a total of 16,379 neonates were received by Xinxiang Center Hospital, of which 61 cases were diagnosed with Streptococcus agalactiae and the annual infection rate was 3.72‰. The infection rate decreased slowly with the year and there was no significant difference in different years between the two groups (P>0.05). The infection rates of Streptococcus agalactiae in the second and third quarters were relatively high, but the difference in infection rates was not statistically significant among quarters (P>0.05). The infection rate of Streptococcus agalactiae in male newborns was slightly higher than that of female newborns (P>0.05). The infection rate of Streptococcus agalactiae was higher in neonates with 32-week-to-gestational age group, and there was a statistically significant difference among different gestational ages (P<0.05). The infection rate of neonatal Streptococcus agalactiae was higher in 1.5kg-to-birth weight group, and there was a statistically significant difference among different birth weights (P<0.05). The infection rate of Streptococcus agalactiae in neonates through vaginal delivery was significantly higher than that of neonates through cesarean section (P<0.05). The infection rate of neonatal Streptococcus agalactiae was higher in 1min Apgar score with 0 point, followed by 4 points~ group, and the difference in different 1min Apgar scores was statistically significant (P<0.05). The results of drug sensitivity test of Streptococcus agalactiae showed that the strain was completely sensitive to cefotaxime, meropenem, linezolid, vancomycin, penicillin, and ampicillin, but resistant to erythromycin (73.77%) and clindamycin (72.13%). Conclusion The infection risk was high in neonates with premature birth, low birth weight, vaginal delivery, and hypoxic signs in our hospital. The clinical sensory control and prevention of Streptococcus agalactiae in obstetrics department can be intervened according to its drug resistance characteristics.