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目的探讨早产儿医院感染发病的危险因素。方法回顾性分析2009—2012年本院新生儿科收治的早产儿病例资料,选择生后24 h内入院、住院时间>48 h、除外产前细菌感染史的病例,按照是否发生医院感染分为感染组与非感染组,将胎龄<32周、出生体重<1500 g等13项因素视为可疑危险因素,应用卡方检验及多因素非条件逐步Logistic回归分析明确早产儿医院感染的独立危险因素。结果共纳入588例早产儿,感染组259例,非感染组329例,单因素分析结果显示,胎龄<32周,出生体重<1500 g,开奶日龄>5天、机械通气、经外周中心静脉置管、动脉置管、住院时间>2周、预防性应用抗生素8项因素与医院感染相关;进一步Logistic多因素回归分析显示,胎龄<32周(OR=1.731,95%CI 1.054~2.875)、出生体重<1500 g(OR=1.843,95%CI1.052~3.286)及住院时间大于2周(OR=6.445,95%CI 3.883~10.694)为早产儿医院感染的独立危险因素。结论早产儿胎龄越小、出生体重越低、住院时间越长,越易发生医院感染;预防早产儿医院感染的有效措施为加强产前保健,从根本上减少早产儿及低出生体重儿的出生。
Objective To explore the risk factors of nosocomial infection in premature infants. Methods A retrospective analysis of 2009-2012 cases of neonates admitted to our hospital cases of premature children, select the admission within 24 h after birth, hospital stay> 48 h, except for cases of prenatal bacterial infection, according to whether the occurrence of nosocomial infections divided into infection Thirteen factors such as gestational age <32 weeks and birth weight <1500 g were considered as suspicious risk factors in the group and non-infected group. Chi-square test and multivariate stepwise Logistic regression analysis were used to identify the independent risk factors of nosocomial infection in preterm infants . Results A total of 588 preterm infants were enrolled, including 259 cases of infection and 329 cases of non-infection. The results of univariate analysis showed that gestational age <32 weeks, birth weight <1500 g, open day> 5 days, mechanical ventilation, Central venous catheterization, arterial catheterization, hospitalization for more than 2 weeks, preventive antibiotics 8 factors associated with nosocomial infection; further Logistic multivariate regression analysis showed that gestational age <32 weeks (OR = 1.731,95% CI 1.054 ~ 2.875), birth weight <1500 g (OR = 1.843, 95% CI 1.052-3.286), and hospital stay longer than 2 weeks (OR = 6.445,95% CI 3.883-10.694) were independent risk factors for nosocomial infection in preterm infants. Conclusions The smaller the gestational age, the lower the birth weight and the longer the hospital stay, the more likely it is to have nosocomial infections. The effective measures to prevent nosocomial infection in preterm infants are to strengthen prenatal care and fundamentally reduce preterm infants and low birth weight infants Born