CAJ | 학술논문

目的：调查新生儿重症监护病房（NICU）医院感染的发生情况，探讨新生儿医院感染的特点，评价NICU医院感染目标性监测及采取干预措施降低医院感染发生的效果。方法：对入住NICU＞48 h的患儿开展医院感染的目标性监测，同时采取一系列综合措施预防控制感染，并对监测结果进行统计分析。结果：共监测病例2201例，干预前后医院感染发病率分别是3.17%和1.28%（P＜0.05）；日感染发病率分别为4.11‰和2.12‰（P＜0.05）；呼吸机相关性肺炎（VAP）日感染发病率分别是3.32‰和5.18‰（P＜0.05）。未见导管相关血流感染（CR-BSI）及导尿管相关尿路感染（CA-UTI）。感染性病原菌以产超广谱β-内酰胺酶（ESBLs）肺炎克雷伯菌多见。结论：目标性监测有利于及时发现NICU医院感染的危险因素，便于为临床提供有针对性的感染控制措施；针对危险因素采取干预措施可以有效降低医院感染的发生。
목적：조사신생인중증감호병방（NICU）의원감염적발생정황，탐토신생인의원감염적특점，평개NICU의원감염목표성감측급채취간예조시강저의원감염발생적효과。방법：대입주NICU＞48 h적환인개전의원감염적목표성감측，동시채취일계렬종합조시예방공제감염，병대감측결과진행통계분석。결과：공감측병례2201례，간예전후의원감염발병솔분별시3.17%화1.28%（P＜0.05）；일감염발병솔분별위4.11‰화2.12‰（P＜0.05）；호흡궤상관성폐염（VAP）일감염발병솔분별시3.32‰화5.18‰（P＜0.05）。미견도관상관혈류감염（CR-BSI）급도뇨관상관뇨로감염（CA-UTI）。감염성병원균이산초엄보β-내선알매（ESBLs）폐염극뢰백균다견。결론：목표성감측유리우급시발현NICU의원감염적위험인소，편우위림상제공유침대성적감염공제조시；침대위험인소채취간예조시가이유효강저의원감염적발생。
Objective:To investigate the incidence of nosocomial infection in neonatal intensive care unit (NICU), to explore its characteristics and to evaluate the effectiveness of targeted monitoring and intervention measures in the preven-tion of nosocomial infection. Methods: Targeted surveillance was carried out for the neonates enrolled in NICU over 48 hours, at the same time a series of measures were taken for the prevention and control of infection and the surveillance re-sults were analyzed. Results: Among 2 201 monitoring cases the nosocomial infection rate before and after the intervention was 3.17%and 1.28% (P<0.05) respectively, the daily infection rate was 4.11‰and 2.12‰(P<0.05), and the inci-dence of ventilator-associated pneumonia(VAP) per patient day was 3.32‰and 5.18‰(P<0.05). There was no catheter related blood stream infection (CR-BSI) and catheter-associated urinary tract infection (CA-UTI). The main pathogens were extended spectrum beta-lactamases (ESBLs)-producing Klebsiella pneumoniae subs. pneumoniae. Conclusion: Tar-geted surveillance was helpful to discover the risk factors of the nosocomial infection in NICU and to provide effective con-trol measures for clinical application. Prevention measures against various risk factors can effectively reduce the incidence of nosocomial infection.