新生儿PICC相关血流感染的危险因素

Peripherally inserted central catheter-related bloodstream infection in neonates

目的探讨新生儿经外周静脉穿刺中心静脉置管(PICC)相关血流感染的发病情况及危险因素。方法回顾性分析某院2016年1月-2017年12月新生儿病房PICC导管相关血流感染(CRBSI)的发生情况,分别采用单因素和多因素分析CRBSI的危险因素。结果共有424例PICC置管新生儿,总置管日数为9 207 d,53例新生儿发生CRBSI,发病率为5.76/1 000导管日。共检出57株病原菌,主要为革兰阳性菌(20株,占35.09%)。危险因素分析结果显示,出生体质量≤1 500 g、置管日数≥20 d、5 min Apgar评分≤7分是PICC置管新生儿发生CRBSI的独立危险因素。结论医务人员可采取针对性措施减少新生儿CRBSI的发生,尤其是出生体质量低于1 500 g、出生5 min Apgar评分≤7分、置管日数≥20 d的新生儿。

Objective To investigate the incidence and risk factors of peripherally inserted central catheter(PICC)-related bloodstream infection in neonates. Methods The occurrence of catheter-related bloodstream infection(CRBSI) in neonates receiving PICC in a neonatal ward from January 2016 to December 2017 was analyzed retrospectively, risk factors for CRBSI were analyzed by univariate and multivariate analysis respectively. Results A total of 424 neonates with PICC had CRBSI, the total PICC days were 9 207 days, 53 children had CRBSI, incidence of CRBSI was 5.76/1 000 catheter-days. 57 strains of pathogenic bacteria were isolated, mainly gram -positive bacteria ( n =20 strains, 35.09%). Risk factor analysis showed that birth weight ≤1 500 g, catheterization days≥20 days, 5-min Apgar score≤7 were independent risk factors for CRBSI in neonates receiving PICC. Conclusion Health care wor-kers can take targeted measures to reduce the incidence of CRBSI in neonates, especially those with birth weight <1 500 g , 5-min Apgar score≤7, and indwelling days≥20 days.