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危重新生儿不同类型中心静脉导管血流感染的发生。

Occurrence of bloodstream infection with different types of central vascular catheter in critically neonates.

机构信息

Uberlandia Federal University, Avenue Pará, 1720. Postal code: 38400-902, Uberlandia- MG, Brazil.

出版信息

J Infect. 2010 Feb;60(2):128-32. doi: 10.1016/j.jinf.2009.11.007. Epub 2009 Nov 26.

Abstract

OBJECTIVE

The aim of this research was to assess the incidence of CVC-associated/related to bloodstream infection (BSI) to different types of CVC, by classes of neonatal birth weight.

METHODS

The research was conducted in the Neonatal Intensive Care Unit of Uberlandia University Hospital from April/2006 through April/2008. The population analyzed comprised neonates who had at least one CVC placed for longer than 24h, followed-up through epidemiologic vigilance "National Healthcare Safety Network". Patients were followed daily from their entry into the study to their discharge or death.

RESULTS

At birth, 50.7% of neonates had low weight (< or = 1500g), 24.5% between 1501 and 2500g and 24.8% over 2500g. The highest density of CVC use (0.96) was found in neonates with birth weight ranging from 751g to 1000g. The incidence of CVC-associated/related to BSI was 13.0 and 2.1 per 1000 days CVC, respectively, and the higher representativeness in the weight group of 1501-2500g (15.8) and < or = 750g (3.3), respectively. A higher proportion of CVC-associated to BSI was observed in PICC (6.0) than in the other CVCs (P<0.01). Coagulase negative Staphylococcus was the most common microorganism (39.7%) in BSI, followed by Staphylococcus aureus (24. 6%) and Gram-negative bacilli (19.2%).

CONCLUSION

Although neonates weighing less than 750g comprise the group with lower representativeness at the unit (5.4%), they reveal the highest CVC related to BSI incidence rate (3.3/1000 days CVC).

摘要

目的

本研究旨在评估不同类型中心静脉导管(CVC)与新生儿出生体重分类相关的血流感染(BSI)发生率。

方法

本研究于 2006 年 4 月至 2008 年 4 月在 Uberlandia 大学医院新生儿重症监护病房进行。分析人群包括至少留置 CVC 24 小时以上的新生儿,通过流行病学监测“国家医疗保健安全网络”进行随访。患者从进入研究开始,每天进行随访,直到出院或死亡。

结果

出生时,50.7%的新生儿体重较低(≤1500g),24.5%体重在 1501-2500g 之间,24.8%体重超过 2500g。CVC 使用密度最高(0.96)的是体重在 751-1000g 的新生儿。CVC 相关性/相关 BSI 的发生率分别为每 1000 天 CVC 13.0 和 2.1,体重在 1501-2500g 组(15.8)和≤750g 组(3.3)的代表性更高。PICC 相关性 BSI 的比例(6.0)高于其他 CVC(P<0.01)。BSI 中最常见的微生物是凝固酶阴性葡萄球菌(39.7%),其次是金黄色葡萄球菌(24.6%)和革兰氏阴性杆菌(19.2%)。

结论

尽管体重低于 750g 的新生儿在该单位的代表性较低(5.4%),但他们显示出最高的 CVC 相关性 BSI 发生率(3.3/1000 天 CVC)。

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