Orsi Giovanni Battista, d'Ettorre Gabriella, Panero Alessandra, Chiarini Fernanda, Vullo Vincenzo, Venditti Mario
Department of Public Health Sciences, La Sapienza University, Rome, Italy.
Am J Infect Control. 2009 Apr;37(3):201-3. doi: 10.1016/j.ajic.2008.05.009. Epub 2008 Dec 6.
Hospital-acquired infections (HAIs) represent an important cause of morbidity and mortality in neonatal intensive care units (NICUs).
All neonates admitted for > 48 hours between January 2003 and December 2006 in the NICU of the teaching hospital Umberto I of Rome, Italy were considered.
Of the 575 neonates evaluated, 76 (13.2%) developed a total of 100 HAIs, including 36 bloodstream infections (BSIs), 33 pneumonias, 19 urinary tract infections, 8 conjunctivitis, and 4 onphalitis. There were 7.8 HAIs/1000 patient-days and 12.5 BSIs/1000 days of umbilical catheterization. Logistic analysis identified an association with mechanical ventilation (odds ratio [OR] = 3.05; 95% confidence interval [CI] = 1.75 to 5.31; P < .01) and birth weight <or= 1500 g (OR = 2.34; 95% CI = 1.36 to 4.03; P < .01). Thirty-five neonates (6.1%) died. Klebsiella pneumoniae (37.7%) and coagulase-negative staphylococci (28.6%) were the most frequently isolated microorganisms. Only 3 Candida spp determined BSIs (8.3%). BSI mortality was higher in infections with gram-negative pathogens (36.4%) than in infections with gram-positive pathogens (4.5%).
Although we found a low infection and mortality rate, attention should be directed toward antibiotic-resistant gram-negative pathogens.
医院获得性感染（HAIs）是新生儿重症监护病房（NICUs）发病和死亡的重要原因。
纳入2003年1月至2006年12月期间在意大利罗马翁贝托一世教学医院新生儿重症监护病房住院超过48小时的所有新生儿。
在评估的575例新生儿中，76例（13.2%）共发生100例医院获得性感染，包括36例血流感染（BSIs）、33例肺炎、19例尿路感染、8例结膜炎和4例脐炎。每1000个患者日有7.8例医院获得性感染，每1000天脐静脉置管有12.5例血流感染。逻辑分析确定与机械通气有关（比值比[OR]=3.05；95%置信区间[CI]=1.75至5.31；P<.01），以及出生体重≤1500 g（OR=2.34；95%CI=1.36至4.03；P<.01）。35例新生儿（6.1%）死亡。肺炎克雷伯菌（37.7%）和凝固酶阴性葡萄球菌（28.6%）是最常分离出的微生物。仅3株念珠菌属导致血流感染（8.3%）。革兰阴性病原体感染的血流感染死亡率（36.4%）高于革兰阳性病原体感染（4.5%）。
尽管我们发现感染率和死亡率较低，但应关注耐抗生素的革兰阴性病原体。
