Nambiar Sumathi, Singh Nalini
Department of Intectious Deseases, Children's National Medical Center, Washington DC 20010, USA.
Pediatr Infect Dis J. 2002 Sep;21(9):839-42. doi: 10.1097/00006454-200209000-00011.
Gram-negative rods (GNR) and species are important causes of health care-associated infections in neonatal intensive care units (NICUs). In prior reports, Gram-positive cocci (GPC) have been identified as the most common pathogens causing nosocomial infections in NICUs.
To describe the epidemiology of health care-associated infections in a Level III NICU at a free-standing children's hospital.
All health care-associated infections in neonates from August 1996 to July 2001 were analyzed. Data were collected prospectively by standard surveillance protocols and nosocomial infection site definitions from the National Nosocomial Infection Surveillance system of the Centers for Disease Control and Prevention.
During the 5-year study period, 665 pathogens caused 640 infections in the NICU. GNR were the most common pathogens isolated. Of the 665 pathogens 284 (43%) were GNR, followed by 223 (33.5%) GPC, 106 (16%) fungi and 52 (8%) others. spp. were the most common GNR isolated. Ceftazidime resistance was present in 56 of 81 (69%) isolates. Bloodstream and lower respiratory tract infections were the most common sites of infection. More than one-half of the pathogens (388 of 665) were isolated from neonates weighing < or =1000 g.
There is a change in the epidemiology of health care-associated infections in our NICU with a predominance of GNR. This change can impact choice of antimicrobials for the empiric treatment of health care-associated infections in high risk neonates.
革兰氏阴性杆菌（GNR）及其菌种是新生儿重症监护病房（NICU）中与医疗保健相关感染的重要原因。在先前的报告中，革兰氏阳性球菌（GPC）已被确定为NICU中引起医院感染的最常见病原体。
描述一家独立儿童医院三级NICU中与医疗保健相关感染的流行病学情况。
分析了1996年8月至2001年7月新生儿的所有与医疗保健相关感染。数据通过标准监测方案和疾病控制与预防中心国家医院感染监测系统的医院感染部位定义进行前瞻性收集。
在为期5年的研究期间，665种病原体在NICU中导致了640例感染。GNR是分离出的最常见病原体。在665种病原体中，284种（43%）为GNR，其次是223种（33.5%）GPC、106种（16%）真菌和52种（8%）其他病原体。 菌种是分离出的最常见GNR。81株分离株中有56株（69%）对头孢他啶耐药。血流感染和下呼吸道感染是最常见的感染部位。超过一半的病原体（665种中的388种）是从体重≤1000g的新生儿中分离出来的。
我们NICU中与医疗保健相关感染的流行病学发生了变化，以GNR为主。这种变化会影响高危新生儿医疗保健相关感染经验性治疗抗菌药物的选择。
