论文部分内容阅读
目的探讨导致早产儿医院感染败血症发生的危险因素及病原菌分布情况。方法对2008年1月～2011年12月期间在某院儿科住院的1243例早产儿病历资料进行回顾性分析。结果 1243例早产儿中发生医院感染败血症患儿41例,发生率3.30%,死亡2例,死亡率4.88%;血培养共培养出48株病原菌,其中革兰阴性菌28株,占感染病原菌58.33%,革兰阳性菌16例,占感染病原菌33.33%,真菌4例,占感染病原菌8.33%;革兰阴性菌以肺炎克雷伯菌(22.92%)、铜绿假单胞菌(16.67%)、大肠埃希氏菌(8.33%)、鲍曼不动杆菌(4.17%)为主,革兰阳性菌以金黄色葡萄球菌(14.58%)、表皮葡萄球菌(8.33%)、溶血葡萄球菌(4.17%)为主,真菌以白色念珠菌(4.17%)为主;胎龄、出生体重、机械通气、中心静脉置管、应用广谱抗生素是导致早产儿败血症发生的危险因素(均P﹤0.01)。结论导致早产儿医院感染败血症的发生的危险因素主要是胎龄、出生体重、机械通气、中心静脉置管、应用广谱抗生素,而感染病原菌以肺炎克雷伯菌、铜绿假单胞菌金黄色葡萄球菌等病原菌为主要病原菌。
Objective To explore the risk factors and pathogens distribution of septicemia in premature infants with hospital infection. Methods The data of 1243 cases of premature infants hospitalized in pediatric department from January 2008 to December 2011 were analyzed retrospectively. Results 41 cases of nosocomial sepsis occurred in 1243 premature infants, with a incidence of 3.30% and 2 deaths with a mortality rate of 4.88%. 48 strains of pathogens were co-cultured in blood culture, of which 28 were Gram-negative bacteria accounting for 58.33 %, Gram-positive bacteria in 16 cases, accounting for 33.33% of the infected pathogens, fungi in 4 cases, accounting for 8.33% of infected pathogens; Gram-negative bacteria with Klebsiella pneumoniae (22.92%), Pseudomonas aeruginosa (16.67% Escherichia coli (8.33%) and Acinetobacter baumannii (4.17%). Gram-positive bacteria were Staphylococcus aureus (14.58%), Staphylococcus epidermidis (8.33%), Staphylococcus haemolyticus (4.17% ). The majority of fungi were Candida albicans (4.17%). The gestational age, birth weight, mechanical ventilation, central venous catheterization and broad-spectrum antibiotics were the risk factors of sepsis in preterm infants (all P <0.01). Conclusions The risk factors of nosocomial sepsis in premature infants are mainly gestational age, birth weight, mechanical ventilation, central venous catheterization and broad-spectrum antibiotics. The pathogenic bacteria are Klebsiella pneumoniae, Pseudomonas aeruginosa golden yellow Staphylococcus aureus and other pathogens as the main pathogen.