Auriti C, Maccallini A, Di Liso G, Di Ciommo V, Ronchetti M P, Orzalesi M
Division of Neonatal Intensive Care, Bambino Gesù Children's Hospital, Rome, Italy.
J Hosp Infect. 2003 Jan;53(1):25-30. doi: 10.1053/jhin.2002.1341.
The clinical records a years cohort of 280 newborn infants consecutively hospitalized for 48 h or more in our neonatal intensive-care unit (NICU) were reviewed. Information on the infants' conditions during the first 12h of life, and on the procedures used in the NICU, were collected. Statistical significance was tested by univariate analysis with the chi(2) test and by multivariate logistic regression analysis with the software program SPSS (Version 10). Over the one-year period reviewed, 90 hospital-acquired infections (HAIs) were contracted; 55 (19.6%) of infants had at least one infection during their stay. The overall in-hospital mortality was 7.1%, and mortality was higher in infants in whom at least one infection developed than in non-infected infants (12.7 vs. 5.8% P=0.13). Very low birthweight infants (VLBW<1,501 g) who had more severe clinical conditions on admission [clinical risk index for babies (CRIB) score >/=5] had an almost two-fold higher risk of contracting a HAI. In the multivariate regression analysis, the onset of a HAI was strongly associated with a low gestational age and the presence of an intravascular catheter. HAIs frequently complicate hospitalization in NICUs and are associated with increased mortality. Our findings also suggest that CRIB could be predictive for the risk of infection in VLBW infants.
回顾了在我们新生儿重症监护病房（NICU）连续住院48小时及以上的280例新生儿一年队列的临床记录。收集了婴儿出生后前12小时的病情信息以及NICU所采用的治疗程序。通过卡方检验进行单因素分析，并使用SPSS软件程序（版本10）进行多因素逻辑回归分析来检验统计学意义。在回顾的一年期间，发生了90例医院获得性感染（HAI）；55例（19.6%）婴儿在住院期间至少发生了一次感染。总体住院死亡率为7.1%，至少发生一次感染的婴儿的死亡率高于未感染婴儿（12.7%对5.8%，P = 0.13）。入院时临床状况更严重[婴儿临床风险指数（CRIB）评分≥5]的极低出生体重婴儿（VLBW＜1501g）发生HAI的风险几乎高出两倍。在多因素回归分析中，HAI的发生与孕周小和血管内导管的存在密切相关。HAI经常使NICU住院复杂化，并与死亡率增加相关。我们的研究结果还表明，CRIB可以预测VLBW婴儿的感染风险。
