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目的分析新生儿重症监护室医院感染的危险因素、特点及预防措施。方法对2004～2006年我院新生儿重症监护室发生医院感染83例新生儿病历进行回顾性总结分析。结果总医院感染率3.39%,早产儿医院感染率5.27%,足月儿医院感染率2.79%。感染部位主要以呼吸道及血液为主。医院感染患儿中有病原学诊断者47例,共检出细菌39株,革兰阴性菌33株(84.6%),以肺炎克雷伯氏菌为主,革兰阳性菌6株(15.4%),以表皮葡萄球菌为主。病毒16株,其中轮状病毒15株,呼吸道合胞病毒1株。医院感染革兰阴性菌对碳青霉烯类敏感,革兰氏阳性球菌对万古霉素敏感,均对青霉素及第二、三代头孢菌素耐药率高。发生医院感染患儿97%住院初期均使用第二、三代头孢菌素防治感染。结论早产儿医院感染率明显高于足月儿医院感染率,医院感染的菌株耐药性高。严格控制预防性使用广谱抗生素,是预防新生儿监护室医院感染的关键。
Objective To analyze the risk factors, characteristics and preventive measures of nosocomial infection in neonatal intensive care unit. Methods A retrospective analysis of 83 neonates with nosocomial infection in neonates with intensive care unit from 2004 to 2006 in our hospital was conducted. Results The total hospital infection rate was 3.39%, premature infants hospital infection rate was 5.27%, full-term hospital infection rate 2.79%. Infections are mainly respiratory and blood-based. There were 47 etiological diagnoses among children with nosocomial infection, of which 39 were bacteria, 33 (84.6%) were Gram-negative bacteria, Klebsiella pneumonia, 6 were Gram-positive bacteria (15.4% ), Mainly Staphylococcus epidermidis. 16 strains of viruses, including 15 rotavirus strains and 1 respiratory syncytial virus. Gram-negative bacteria in hospital are susceptible to carbapenems, Gram-positive cocci are sensitive to vancomycin, both are resistant to penicillin and the second and third generation cephalosporins. 97% of children with nosocomial infection were hospitalized early use of second and third generation cephalosporins prevention and treatment of infection. Conclusion The prevalence of nosocomial infection in preterm infants was significantly higher than that of full-natal infants, and the infection rate of nosocomial infections was high. Strict control of prophylactic use of broad-spectrum antibiotics is the key to preventing nosocomial infections in neonatal care units.