發(fā)布時(shí)間：2018-11-18 11:52

【摘要】：目的：探討新生兒重癥監(jiān)護(hù)病房院內(nèi)感染常見(jiàn)病原菌的分布及進(jìn)行危險(xiǎn)因素分析，對(duì)臨床治療提供理論依據(jù)。方法：對(duì)我院NICU3726例新生兒進(jìn)行統(tǒng)計(jì)，建立對(duì)照組進(jìn)行Logistic回歸分析得出危險(xiǎn)因素。結(jié)果：1)感染現(xiàn)狀：我院新生兒醫(yī)院內(nèi)感染的發(fā)生率為7.7%，呼吸機(jī)相關(guān)性感染率為80.4/1000機(jī)械通氣-天，，胎齡、出生體重與呼吸機(jī)相關(guān)性感染率無(wú)統(tǒng)計(jì)學(xué)意義。2)感染部位：肺部、口腔、血行感染分別占總感染例次的56.7%、8.1%及11.3%。泌尿系統(tǒng)感染及皮膚粘膜感染也占一定比例。3)醫(yī)院感染病原菌分布為：G+菌占分離菌株37.6%；G-菌占分離菌株60.3%。4)危險(xiǎn)因素：出生體重≤1500g、胎齡≤32周、小于胎齡兒、新生兒窒息、腸外營(yíng)養(yǎng)、機(jī)械通氣等為醫(yī)院感染相關(guān)危險(xiǎn)因素(P＜0.001)；其中腸外營(yíng)養(yǎng)，出生體重≤1500g，機(jī)械通氣為主要危險(xiǎn)因素(OR值分別為：8.135，3.142，2.377)。結(jié)論：1)我院新生兒醫(yī)院感染發(fā)生率偏低，主要為肺部感染。2)新生兒院內(nèi)感染以革蘭氏陰性菌為主，常見(jiàn)菌為肺炎克雷伯菌及大腸桿菌。革蘭氏陽(yáng)性菌感染以草綠色鏈球菌及金黃色葡萄球菌多見(jiàn)。3)出生體重≤1500g、小于胎齡兒、出生合并窒息史、胎齡≤32周，腸外營(yíng)養(yǎng)、機(jī)械通氣為醫(yī)院感染相關(guān)危險(xiǎn)因素。出生體重≤1500g，腸外營(yíng)養(yǎng)，機(jī)械通氣為我院NICU醫(yī)院感染的主要危險(xiǎn)因素。4)預(yù)防措施：嚴(yán)格手衛(wèi)生，掌握機(jī)械通氣指征，執(zhí)行無(wú)菌操作，合理安排清理呼吸道頻率，避免反復(fù)插管，縮短機(jī)械通氣時(shí)間，加強(qiáng)早期微量喂養(yǎng)等可起到預(yù)防醫(yī)院感染的作用。
[Abstract]:Objective: to investigate the distribution and risk factors of common pathogens of nosocomial infection in neonatal intensive care unit (NICU) and to provide theoretical basis for clinical treatment. Methods: the risk factors of NICU3726 neonates were analyzed by Logistic regression analysis. Results: 1) infection status: the incidence of nosocomial infection of neonates in our hospital was 7.7, and the ventilator-associated infection rate was 80.41000% mechanical ventilation days, gestational age. There was no significant difference between birth weight and ventilator-associated infection rate. 2) infection sites: lung, oral cavity and blood accounted for 56.1% and 11.3% of the total infection respectively. Urinary tract infection and skin and mucous membrane infection also accounted for a certain proportion. 3) the distribution of nosocomial infection pathogenic bacteria was: G bacteria accounted for the isolated strain 37.6; The risk factors of nosocomial infection were: birth weight 鈮

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