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目的探讨新生儿医院感染的危险因素及病原菌耐药情况,为医院感染控制提供依据。方法对2012年1月-12月住院48 h以上的新生儿进行医院感染目标性监测及感染因素分析。结果新生儿共发生54例医院感染,感染发病率为1.25%,发生部位依次为呼吸道(占66.7%)、胃肠道(占18.5%)、皮肤软组织(占9.2%)。出生体质量越低(χ2Trend=126.88,P<0.001)、住院时间越长(χ2Trend=106.89,P<0.001),发生医院感染的比例或风险越高;有侵袭性操作的新生儿发生医院感染的风险增高(χ2=5.338,P=0.021);新生儿医院感染与性别无关(χ2=0.984,P=0.321)。在54例新生儿医院感染患儿体内共分离出54株病原菌,其中G+菌23株,占42.6%,主要G+菌对青霉素及大环内酯类抗生素普遍耐药;G-菌31株,占57.4%,G-菌对第3代头孢菌素类抗生素耐药性最高。结论新生儿医院感染发病率较低,出生体质量、住院时间及侵袭性操作是新生儿发生院内感染的危险因素。
Objective To investigate the risk factors of nosocomial infection in neonates and the drug resistance of pathogens so as to provide basis for the control of nosocomial infection. Methods The target surveillance and infection factors of nosocomial infection in neonates who were hospitalized for more than 48 h from January to December in 2012 were analyzed. Results A total of 54 cases of nosocomial infection occurred in neonates. The incidence of infection was 1.25%. The incidence of respiratory infections was 66.7%, gastrointestinal tract (18.5%) and skin soft tissue (9.2%). The lower the birth weight (χ2Trend = 126.88, P <0.001), the longer the hospital stay (χ2Trend = 106.89, P <0.001), the higher the proportion or risk of nosocomial infections; nociceptive nocturnal The risk was higher (χ2 = 5.338, P = 0.021). Neonatal hospital infection was not related to sex (χ2 = 0.984, P = 0.321). 54 strains of pathogens were isolated in 54 neonates with nosocomial infection, of which 23 strains were G + bacteria (42.6%). The major G + bacteria were generally resistant to penicillin and macrolide antibiotics; 31 strains of G- 57.4%, G-bacteria on the third generation cephalosporins antibiotic resistance. Conclusions Neonatal nosocomial infection is lower in incidence, birth weight, length of hospital stay and aggressive operation are risk factors for neonatal nosocomial infection.