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南美洲哥伦比亚部分新生儿重症监护病房医院感染的流行病学研究

Epidemiology of nosocomial infections in selected neonatal intensive care units in Colombia, South America.

作者信息

Efird Meica M, Rojas Mario A, Lozano Juan M, Bose Carl L, Rojas María X, Rondón Martín A, Ruiz Gloria, Piñeros Juan G, Rojas Catherine, Robayo Guillermo, Hoyos Angela, Gosendi Maria E, Cruz Hernan, Leon Angela

机构信息

University of North Carolina (M.M.E., M.A.R., C.L.B.), Chapel Hill, North Carolina, USA.

出版信息

J Perinatol. 2005 Aug;25(8):531-6. doi: 10.1038/sj.jp.7211345.

Abstract

OBJECTIVE

The epidemiology of nosocomial infections (NI) in neonatal intensive care units in developing countries has been poorly studied. We conducted a prospective study in selected neonatal units in Colombia, SA, to describe the incidence rate, causative organisms, and interinstitutional differences.

STUDY DESIGN

Data were collected prospectively from February 20 to August 30, 2001 from eight neonatal units. NI was defined as culture-proven infection diagnosed after 72 h of hospitalization, resulting in treatment with antibiotics for >3 days. Linear regression models were used to describe associations between institutional variables and NI rates.

RESULTS

A total of 1504 infants were hospitalized for more than 72 h, and therefore, at risk for NI. Of all, 127 infections were reported among 80 patients (5.3%). The incidence density rate was 6.2 per 1000 patient-days. Bloodstream infections accounted for 78% of NIs. Gram-negative organisms predominated over gram-positive organisms (55 vs 38%) and were prevalent in infants < or =2000 g (54%). The most common pathogens were Staphylococcus epidermidis (26%) and Klebsiella pneumonia (12%).

CONCLUSION

Gram-negative organisms predominate in Colombia among infants <2000 g. The emergence of gram-negative organisms and their associated risk factors requires further study.

摘要

目的

发展中国家新生儿重症监护病房医院感染(NI)的流行病学研究较少。我们在南美洲哥伦比亚的选定新生儿病房进行了一项前瞻性研究,以描述发病率、致病微生物及机构间差异。

研究设计

于2001年2月20日至8月30日前瞻性收集了8个新生儿病房的数据。NI定义为住院72小时后经培养证实的感染,需使用抗生素治疗超过3天。采用线性回归模型描述机构变量与NI发生率之间的关联。

结果

共有1504名婴儿住院超过72小时,因此有发生NI的风险。其中,80名患者报告了127例感染(5.3%)。发病密度率为每1000患者日6.2例。血流感染占NI的78%。革兰阴性菌多于革兰阳性菌(55%对38%),且在体重≤2000g的婴儿中更为常见(54%)。最常见的病原体是表皮葡萄球菌(26%)和肺炎克雷伯菌(12%)。

结论

在哥伦比亚,体重<2000g的婴儿中革兰阴性菌占主导。革兰阴性菌的出现及其相关危险因素需要进一步研究。

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