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目的:了解新生儿院内血流感染的危险因素、病原菌及其耐药谱,为有效防治提供科学依据。方法:采用回顾性调查方法,调查分析武汉某医院2010~2013年新生儿病房发生院内血流感染149例患儿的临床资料、微生物检查结果。结果:新生儿院内血流感染前三位最常见的病原菌依次为:凝固酶阴性葡萄球菌(31.8%)、金黄色葡萄球菌(23.2%)、大肠埃希菌(18.5%),G-菌及真菌感染的比例有增加趋势;G+菌对青霉素及红霉素大部分耐药,对万古霉素均敏感;G-菌对氨苄西林及头孢菌素高度耐药,对亚胺培南敏感;发生院内血流感染的独立危险因素为:早产(<32周)、出生体重≤1 500 g、中心静脉置管及气管插管。结论:新生儿院内血流感染病原菌中G-菌及真菌感染有增加趋势,病原菌多重耐药严重,新生儿病房应严格消毒隔离措施及无菌操作原则,严格各种留置导管适应证,避免院内血流感染的发生。
Objective: To understand the risk factors of neonatal nosocomial infection, pathogenic bacteria and their drug resistance spectrum, to provide a scientific basis for effective prevention and treatment. Methods: A retrospective investigation was conducted to investigate the clinical data and microbiological findings of 149 cases of nosocomial bloodstream infections in neonatal wards in a hospital in Wuhan from 2010 to 2013. Results: The most common pathogens of the first three cases of nosocomial bloodstream infections were coagulase negative staphylococcus (31.8%), Staphylococcus aureus (23.2%), Escherichia coli (18.5%), G- Fungal infections have an increasing trend; G + bacteria most of penicillin and erythromycin resistance, are sensitive to vancomycin; G- bacteria are highly resistant to ampicillin and cephalosporin, sensitive to imipenem; occurred Independent risk factors for nosocomial bloodstream infections were premature delivery (<32 weeks), birth weight ≤1,500 g, central venous catheterization and endotracheal intubation. CONCLUSION: G-bacteria and fungal infections in neonates with nosocomial bloodstream infections tend to increase, and the multi-drug resistance of pathogens is serious. Neonatal wards should be strictly sterilized and sterilized, and the principle of aseptic technique should be strictly followed. Indications of indwelling catheters The occurrence of bloodstream infection.