Cai Xiao-Di, Cao Yun, Chen Chao, Yang Yi, Wang Chuan-Qing, Zhang Lan, Ding Hong
Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2010 Feb;12(2):81-4.
A perspective study was conducted to describe the epidemiologic profile of nosocomial infection in the neonatal intensive care unit (NICU).
The newborn infants who were admitted in the NICU for more than 48 hrs were enrolled from February 2006 to January 2007. The clinical data were collected. The rate of nosocomial infection was calculated according to the CDC surveillance system. The risk factors of nosocomial infection were investigated by multivariate regression analysis.
A total of 1 159 neonates were recruited. A total of 169 nosocomial infections occurred, with a cumulative rate for nosocomial infection of 14.58%. The incidence of nosocomial infection was 19.52 per 1 000 patient-days. Ninety-two cases of pneumonia, including 38 cases of ventilator-associated pneumonia (VAP), were reported, with a nosocomial infection rate of 7.94%, which was the most common nosocomial infection in the NICU. Among these infants the rate of VAP was 48.8 per 1 000 ventilator days. The major microorganisms isolated from the infected patients were Acinetobacter baumannii, Klebsiella pneumoniae, Coagulase negative staphylococcus, and aeruginosus Bacillus. Birth weight (OR 2.130, 95%CI 1.466-3.094), mechanical ventilation (OR 7.038, 95%CI 3.901-12.698), chest tube drainage (OR 7.004, 95%CI 1.841-26.653) and ibuprofen therapy (OR 2.907, 95% CI 1.303-6.487) were the risk factors for the development of nosocomial infection.
Pulmonary infection is the most common nosocomial infection in the NICU, and the Gram-negative bacillus is the main pathogen. Low birth weight, mechanical ventilation, chest tube drainage and ibuprofen therapy are independent risk factors for nosocomial infection in the NICU.
开展一项前瞻性研究以描述新生儿重症监护病房（NICU）医院感染的流行病学特征。
选取2006年2月至2007年1月期间入住NICU超过48小时的新生儿。收集临床资料。根据美国疾病控制与预防中心（CDC）监测系统计算医院感染率。通过多因素回归分析调查医院感染的危险因素。
共纳入1159例新生儿。发生医院感染169例，医院感染累积发生率为14.58%。医院感染发病率为每1000患者日19.52例。报告92例肺炎，其中包括38例呼吸机相关性肺炎（VAP），医院感染率为7.94%，这是NICU最常见的医院感染。在这些婴儿中，VAP发生率为每1000呼吸机日48.8例。从感染患者中分离出的主要微生物为鲍曼不动杆菌、肺炎克雷伯菌、凝固酶阴性葡萄球菌和铜绿假单胞菌。出生体重（比值比[OR]2.130，95%可信区间[CI]1.466 - 3.094）、机械通气（OR 7.038，95%CI 3.901 - 12.698）、胸管引流（OR 7.004，95%CI 1.841 - 26.653）和布洛芬治疗（OR 2.907，95%CI 1.303 - 6.487）是医院感染发生的危险因素。
肺部感染是NICU最常见的医院感染，革兰阴性杆菌是主要病原体。低出生体重、机械通气、胸管引流和布洛芬治疗是NICU医院感染的独立危险因素。
