新生儿重症监护病房医院感染流行病学多中心研究
신생인중증감호병방의원감염류행병학다중심연구
Multicenter study on epidemiology of healthcare-associated infection in neonatal intensive care units
  • 万方数据
    中国感染控制杂志 중국감염공제잡지
    Chinese Journal of Infection Control
    2015年 10期 649-653 ,共5页

    贾会学%殷环%吴安华%胡必杰%张秀月%侯铁英%宗志勇%李卫光%杨怀%杨芸%刘运喜%文建国%陆群%李六亿

    가회학%은배%오안화%호필걸%장수월%후철영%종지용%리위광%양부%양예%류운희%문건국%륙군%리륙억

    新生儿监护病房%NICU%医院感染%例次感染率%日感染率%流行病学%多中心研究 新生兒鑑護病房%NICU%醫院感染%例次感染率%日感染率%流行病學%多中心研究
    신생인감호병방%NICU%의원감염%례차감염솔%일감염솔%류행병학%다중심연구
    neonatal intensive care unit%healthcare-associated infection%infection case rate%infection rate per 1 000 patient-days%epidemiology%multicenter study
    目的：了解我国三级甲等综合医院新生儿监护病房（NICU）医院感染的流行特点，为预防和控制新生儿医院感染提供科学依据。方法以多中心研究的方式，选取全国9省17所医院，按照统一的诊断标准和方法对2013年10月—2014年9月 NICU 住院新生儿的医院感染情况进行前瞻性监测。结果共监测12998例 NICU住院新生儿，发生436例次医院感染，例次发病率为3．35％，住院总日数为126125 d，日发病率为3．46‰。新生儿医院感染例次发病率随新生儿出生体重的增加而下降（χ2＝291．55，P ＜0．001）。不同规模 NICU 新生儿医院感染发病率比较，差异有统计学意义（χ2＝49．77，P ＜0．001），床位数＞30张的 NICU 新生儿医院感染例次发病率和日发病率最高；NICU 新生儿医院感染例次发病率以西南地区（10．36％）最高，日发病率以华南地区（10．52‰）最高。感染部位以下呼吸道和血液为主；感染病原体以肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌为主。结论我国NICU 不同出生体重组、不同规模、不同地区的新生儿医院感染发病率不同，应继续加强监测，根据感染特点指导各项防控措施的落实。
    목적：료해아국삼급갑등종합의원신생인감호병방（NICU）의원감염적류행특점，위예방화공제신생인의원감염제공과학의거。방법이다중심연구적방식，선취전국9성17소의원，안조통일적진단표준화방법대2013년10월—2014년9월 NICU 주원신생인적의원감염정황진행전첨성감측。결과공감측12998례 NICU주원신생인，발생436례차의원감염，례차발병솔위3．35％，주원총일수위126125 d，일발병솔위3．46‰。신생인의원감염례차발병솔수신생인출생체중적증가이하강（χ2＝291．55，P ＜0．001）。불동규모 NICU 신생인의원감염발병솔비교，차이유통계학의의（χ2＝49．77，P ＜0．001），상위수＞30장적 NICU 신생인의원감염례차발병솔화일발병솔최고；NICU 신생인의원감염례차발병솔이서남지구（10．36％）최고，일발병솔이화남지구（10．52‰）최고。감염부위이하호흡도화혈액위주；감염병원체이폐염극뢰백균、대장애희균、포만불동간균위주。결론아국NICU 불동출생체중조、불동규모、불동지구적신생인의원감염발병솔불동，응계속가강감측，근거감염특점지도각항방공조시적락실。
    Objective To investigate the epidemiological characteristics of healthcare-associated infection (HAI)in neo-natal intensive care units(NICUs)of tertiary first-class hospitals in China,and provide scientific evidence for the prevention and control of neonatal HAI.Methods 17 hospitals in 9 provinces were selected for multicenter study,HAI occurred in neonates at NICUs from October 2013 to September 2014 were surveyed prospectively according to the uniform diagnostic criteria and methods.Results A total of 12 998 neonates were monitored,436 (3.35%)HAI cases occurred,the total patient-days were 126 125 days,incidence of infection was 3.46/1 000 patient-days.HAI cases rate decreased with the in-crease of birth weight (χ2 =291.55,P <0.001).The difference of HAI rate in neonates at different sizes of ICUs were significantly different(χ2 =49.77,P <0.001),infection case rate and infection incidence per 1 000 patient-days were both highest in NICUs with >30 beds;HAI case rate was highest in southwest region(10.36%),infection rate per 1 000 pa-tient-days was the highest in southern China(10.52‰).Lower respiratory tract and bloodstream were the main infection sites;the major pathogens for infection were Klebsiella pneumoniae ,Escherichia coli ,and Acinetobacter baumannii . Conclusion The incidences of HAI in NICUs are different among neonates of different birth weight,at different sizes of ICUs,and at ICUs of different regions,surveillance should be strengthened,prevention and control measures should imple-mented according to infection characteristics.
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