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目的探讨新生儿科住院患儿院内肺部真菌感染(NIPFI)的流行病学及其危险因素。方法选取2006年7月1日-2008年6月30日在广东省人民医院新生儿科住院的患儿中符合院内深部真菌感染(NIFI)诊断标准的婴儿[日龄(77±61)d]共68例。收集患儿一般资料、感染前诊疗经过、标本类型等,并对NIPFI及其他NIFI患儿各项数据进行比较。应用SPSS 13.0软件进行统计学分析。结果住院患儿NIFI发病率为3.31%(68/2 052例),其中NIPFI发生率为1.36%(28/2 052例)。NIPFI患儿总住院时间中位数为15.50 d;心血管疾病患病率为94.6%,感染真菌前广谱抗生素的使用率为96.4%,抗生素的联合应用占64.3%;78.6%的患儿接受了心脏手术;机械通气率为82.1%;中心静脉置管为67.9%;留置胃管率为96.4%;激素使用者占78.6%。NIPFI患儿机械通气率较其他NIFI患儿高(χ2=7.32,P=0.010);余因素在2组患儿间比较差异均无统计学意义。多元回归分析显示机械通气与NIPFI有显著相关性(OR=0.229,95%CI0.072~0.725,P=0.012)。结论在NIFI的各种危险因素中,机械通气是NIPFI的危险因素。
Objective To investigate the epidemiology and risk factors of nosocomial pulmonary fungal infection (NIPFI) in hospitalized neonates. Methods Totally 75 infants (age: 77 ± 61 days) who met the diagnostic criteria of nosocomial deep fungal infection (NIFI) among children hospitalized in Department of Neonatology, Guangdong Provincial People’s Hospital from July 1, 2006 to June 30, 2008 68 cases. Collect general data of children, pre-infection diagnosis and treatment, specimen types, etc., and compare the data of NIPFI and other NIFI children. SPSS 13.0 software was used for statistical analysis. Results The incidence of NIFI in hospitalized children was 3.31% (68/2 052 cases), and the incidence of NIPFI was 1.36% (28/2 052 cases). The median length of hospital stay was 15.50 days in NIPFI patients, 94.6% in cardiovascular disease patients, 96.4% in broad-spectrum antibiotics before infection, 64.3% in antibiotics, 78.6% in children receiving NIPFI Heart surgery; mechanical ventilation rate was 82.1%; central venous catheter was 67.9%; indwelling gastric tube rate was 96.4%; hormone users accounted for 78.6%. The mechanical ventilation rate in children with NIPFI was higher than those in other children with NIFI (χ2 = 7.32, P = 0.010). There was no significant difference in the remaining factors between the two groups. Multivariate regression analysis showed that mechanical ventilation had significant correlation with NIPFI (OR = 0.229, 95% CI0.072-0.725, P = 0.012). Conclusion Among all the NIFI risk factors, mechanical ventilation is a risk factor for NIPFI.