新生儿重症监护病房早产儿医院感染情况分析

目的调查新生儿重症监护病房（NICU）早产儿医院感染的发生情况，分析感染特点及危险因素，为有效预防和控制早产儿医院感染提供依据。方法对2009年6月至2011年5月在新乡医学院第一附属医院NICU住院的1685例早产儿医院感染情况进行统计分析。结果1685例早产儿中发生医院感染279例次，发生率为16．56％；住院日相关的医院感染率为46．87／1000住院日；感染部位以肺炎为主（41．85％），病死率为18．94％。病原菌以革兰阴性菌最多见（57．83％），主要为肺炎克雷白杆菌，其次是鲍曼不动杆菌、大肠杆菌、铜绿假单胞菌等。医院感染组与非医院感染组比较，胎龄更小，体质量更低。早产儿发生医院感染的危险因素主要有机械通气（OR=6．982）、其他有创操作（OR=5．214）、出生体质量≤1500g（OR=3．265）和胎龄≤32周（OR=2．412）。结论革兰阴性菌是最主要的NICU早产儿医院感染病原菌，其中肺炎克雷白杆菌和鲍曼不动杆菌是主要的病原菌；NICU早产儿医院感染的危险因素众多，需高度重视。

Analysis of nosocomial infections of preterm infants in neonatal intensive care unit

Objective To investigate the incidence and trends of nosocomial infections of preterm infants in neonatal intensive care unit（NICU） and to explore the risk factors and strategies to prevent and control the infection. Methods The data of nosocomial infections of 1 685 preterm infants in NICU in the First Affiliated Hospital of Xinxiang Medical University from June 2009 to May 2011 were analyzed. Results There were 279 times of nosocomial infections in 1 685 neonatal pa- tients, the nosocomial infection rate was 16.56%. The incidences density was 46.87 infections per 1 000 hospitalization days. The most common infection was pneumonia（41.85% ） , the mortality rate was 18.94%. The major pathogenic bacteria of the infection in premature infants was gram-negative bacteria （57.83%）. The predominant pathogenic bacteria of gram-negative bacteria was klebsiella pneumoniae, followed by acinetobacter baumannii, escherichia coli and pseudomonas aeruginos. Compared with the non-nosocomial infection group, the gestational age was smaller, the birth weight was lower in nosocomial infection group. Logistic regression analysis indicated that the high risk factors of nosocomial infections included mechanical ventilation （ OR =6. 982） ,the other invasive operations（ OR = 5. 214）, birth weight ≤1 500 g（ OR = 3. 265 ） and gestational age ≤32 weeks （ OR = 2. 412）. Conclusions The main pathogenic bacteria of nosocomial infections of preterm infants in NICU are gram-negative bacteria, and the klebsiella pneumoniae and acinetobactor baumannii are the main bacteria. There are many risk factors of nosocomial infections of preterm infants in NICU and much attention should be paid to the nosocomial infections.