极低出生体重新生儿中心置管相关性血流感染临床特征及病原菌分布

Pathogen distribution and clinical features of central line associated blood stream infection in very low birth weight infants

目的 调查极低出生体重新生儿中心置管相关性血流感染(CLABSI)临床特征及病原菌分布。方法 通过回顾性调查方法,对某医院新生儿重症监护病房(NICU)出生体重<1 500 g的CLABSI感染患儿临床病历资料进行分析。结果 本研究共纳入CLABSI病例134例,平均胎龄<30周,平均出生体重1 200 g。从CLABSI感染患儿病原学标本中鉴定出23种病原菌,共134株,其中革兰阴性菌、革兰阳性菌和真菌分别占60.45%、23.38%和15.67%。肺炎克雷伯菌、近平滑念珠菌和阴沟肠杆菌构成比居前3位。CLABSI并发症及治疗失败率高,其中坏死性小肠结肠炎占23.46%,感染性休克占18.52%,治疗失败占14.81%。结论 极低出生体重新生儿CLABSI病原菌以革兰阴性菌为主,其并发症发生率高,预后较差。

Objective To investigate the clinical characteristics and pathogen distribution of central line associated blood stream infection(CLABSI)in very low birth weight infants.Methods Through a retrospective survey method,the clinical medical records of CLABSI infected infants with a birth weight<1500 g in the neonatal intensive care unit(NICU)of a hospital were analyzed.Results A total of 134 CLABSI cases were included in this study.Mean gestational age was<30 weeks and mean birth weight was 1200 g.A total of 134 strains of 23 pathogens were identified from microbiological specimens of infants with CLABSI infection.Among them,Gram negative bacteria,Gram positive bacteria,and fungi accounted for 60.45%,23.38%,and 15.67%o,respectively.The constituent ratio of Klebsiella pneumoniae,Candida mirabilis,and Clostridium perfringens were the top three.The rates of complications and treatment failure of CLABSI were high,including necrotising enterocolitis(23.46%),septic shock(18.52%),and treatment failure(14.81%).Conclusion The main pathogens of CLABSI in very low birth weight infants are mainly Gram-negative bacteria.The incidence of complications in CLABSI is high,and the prognosis is poor.