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目的:探讨新生儿重症监护室(NICU)院内感染的途径及影响因素,为防控NICU患儿院内感染提供参考。方法:对2012-2014年我院NICU发生院内感染的131例患儿的资料进行回顾性分析,内容包括一般资料(如妊娠周数、入院体质量、住院时间)、侵入性管理、感染部位及菌种等。应用SPSS软件,采用单因素和多因素Logistic回归分析方法,分析NICU院内感染的影响因素和危险因素。结果:我院NICU院内感染发生率为8.7%(131/1 503)。131例NICU院内感染患儿中,呼吸系统感染比例最大(35.9%),其次为原发性血流感染、泌尿系统感染等;呼吸系统感染患儿均使用了呼吸器,44.4%(8/18)的泌尿系统感染患儿使用了导尿管;感染菌中,耐苯唑西林金黄色葡萄球菌比例最大(32.1%),其次是铜绿假单胞菌、肺炎克雷伯菌等。妊娠周数、住院时间、入院体质量、使用呼吸机、静脉全营养、导尿管留置、喂养耐受情况是NICU院内感染的影响因素(P<0.05),其中,住院时间>5 d、入院体质量≤2.5 kg、使用呼吸机、喂养不耐受是NICU感染的独立危险因素(P<0.05)。结论:NICU院内感染的影响因素很多,减少侵入性操作、缩短住院时间、提高喂养耐受性、合理使用抗菌药物以及采取有效的护理措施,能降低NICU院内感染的发生率。
Objective: To explore the ways and influencing factors of neonatal intensive care unit (NICU) nosocomial infection and provide references for prevention and control of nosocomial infections in NICU patients. Methods: Retrospective analysis was performed on the data of 131 children with nosocomial infections in our NICU from 2012 to 2014. The data include general information (such as pregnancy weeks, admission weight, hospital stay), invasive management, site of infection and Bacteria and so on. Using SPSS software, single factor and multivariate Logistic regression analysis were used to analyze the influencing factors and risk factors of nosocomial infection in NICU. Results: The incidence of NICU nosocomial infection in our hospital was 8.7% (131/1 503). Of the 131 NICUS patients, respiratory infections were the most common (35.9%), followed by primary bloodstream infections and urinary tract infections. Respiratory infections were reported in 44.4% (8/18) ) Urinary tract infection in children with urinary tract catheter; Infection bacteria, oxacillin resistant Staphylococcus aureus the largest proportion (32.1%), followed by Pseudomonas aeruginosa, Klebsiella pneumoniae and so on. The number of weeks of pregnancy, hospital stay, body mass, use of ventilator, intravenous nutrition, catheterization and feeding tolerance were the influencing factors of NICU nosocomial infection (P <0.05), of which hospitalization> 5 days Body mass ≤2.5 kg, use of ventilator, feeding intolerance were independent risk factors for NICU infection (P <0.05). Conclusion: There are many influencing factors of nosocomial infections in NICU. Reducing invasive procedures, shortening hospital stay, increasing feeding tolerance, rational use of antimicrobial agents and taking effective nursing interventions can reduce the incidence of nosocomial infections in NICU.