超低出生体重新生儿医院感染特点及危险因素分析

Analysis of the characteristics and the risk factors of the nosocomial infection of neonates with body weight≤1000g

目的:探究超低出生体重新生儿医院感染的特点和感染发生危险因素。方法:本院2020年1月-2023年12月分娩的体重≤1000g的新生儿232例作为研究对象,根据新生儿感染情况分为感染组(n=63)、未感染组(n=169)。分析体重≤1000g新生儿医院感染特点,多因素logistic回归分析医院感染的高危因素。结果:本次调查的232例新生儿出现医院感染63例,发生率为27.2%。主要感染部位为下呼吸道感染52.4%和呼吸机相关肺炎25.4%;共检出病原体48株,排名前3位分别为阴沟肠杆菌(14.6%)、肺炎克雷伯菌(14.6%)和大肠埃希菌(12.5%)。多因素logistic回归分析显示,进行手术、长时间住院、长时间呼吸机辅助呼吸、长时间放置中心静脉导管是医院感染发生的独立危险因素。结论:≤1000g体重新生儿医院感染以下呼吸道感染较常见,临床需重点关注进行过手术、住院时间久、长时间呼吸机辅助呼吸、长时间放置中心静脉导管的低出生体重新生儿。

Objective:To explore the characteristics and the risk factors of the nosocomial infection of neonates with body weight≤1000g.Methods:232 neonates with body weight≤1000g who had delivered in the hospital were selected as the research subjects from January 2020 to December 2023.According to the infection status of the neonates,these neonates were divided into study group(63 neonates with nosocomial infection)and control group(169 without nosocomial infection).The characteristics of the nosocomial infection of these neonates were analyzed,and the high-risk factors of the nosocomial infection of these neonates were analyzed by multivariate Logistic regression analysis.Results:There were 63 neonates with the nosocomial infection in 232 neonates,and with the incidence was 27.2%.The main infection sites of the neonates were the lower respiratory infection(52.4%)and the ventilator-associated pneumonia(25.4%).A total of 48 pathogens of the nosocomial infection were detected,and the top three of which were Enterobacter cloacae(14.6%),Klebsiella pneumoniae(14.6%)and Escherichia coli(12.5%).Multivariate logistic regression analysis showed that the surgery,the prolonged hospitalization,the mechanical ventilation and the placement of central venous catheter of the neonates were the independent risk factors of their nosocomial infection.Conclusion:The lower respiratory tract infection is the more common nosocomial infection of the neonates with body weight≤1000g.It is necessary to pay attention to the neonates with low birth weight who have undergone surgery,long hospitalization time,long-term ventilator-assisted breathing of long-term placement of central venous catheter in clinic.