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目的探讨新生儿重症监护病房(NICU)医院感染的危险因素。方法对2005—2010年我院NICU收治的新生儿临床资料进行回顾性分析,根据是否发生医院感染分为病例组和对照组,分析两组患儿的临床特点及发生医院感染的危险因素。结果纳入的3150例新生儿中发生医院感染256例,发生率8.1%。医院感染与胎龄、出生体重、住院时间、机械通气、外周置入中心静脉导管、胃管留置及胃肠外营养等密切相关(P均<0.05),其中住院时间>14天是医院感染发生的独立危险因素(OR=7.432,95%CI:0.345~6.290)。医院感染病原体以革兰阴性菌为主,其中β-内酰胺酶阳性菌阳性率高(26.2%),耐药性强。结论医院感染的发生与多种因素有关,住院时间越长,发生率越高,应积极治疗基础疾病,加强管理和防范,降低NICU医院感染发生率。
Objective To investigate the risk factors of nosocomial infection in neonatal intensive care unit (NICU). Methods The clinical data of NICU admitted to our hospital from 2005 to 2010 were retrospectively analyzed. According to whether hospital infection occurred or not, the patients were divided into two groups: the case group and the control group. The clinical characteristics and the risk factors of nosocomial infection were analyzed. Results Among the 3,150 newborns enrolled, 256 cases of nosocomial infections occurred, accounting for 8.1%. Nosocomial infection was closely related to gestational age, birth weight, hospital stay, mechanical ventilation, central venous catheter placement, gastric tube indwelling and parenteral nutrition (all P <0.05), of which hospitalization> 14 days was a nosocomial infection The independent risk factors (OR = 7.432, 95% CI: 0.345 ~ 6.290). The main pathogens of nosocomial infection were Gram-negative bacteria, among which the positive rate of β-lactamase-positive bacteria was high (26.2%) and the resistance was strong. Conclusion The occurrence of nosocomial infection is related to many factors. The longer the hospitalization is, the higher the incidence is. Active treatment of underlying diseases should be carried out to strengthen management and prevention and reduce the incidence of nosocomial infections in NICU.