Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland.
J Hosp Infect. 2010 Oct;76(2):156-60. doi: 10.1016/j.jhin.2010.03.020. Epub 2010 Jun 25.
More than one-fifth of patients in neonatal intensive care units (NICUs) have been reported to suffer from healthcare-associated infections (HAIs). The aim of this study was to assess prevalence, onset and types of HAI in Finnish NICU patients. We conducted six monthly point-prevalence surveys in all Finnish NICUs (N=24) between November 2008 and May 2009. For all patients present on the day of survey, the underlying conditions and invasive devices or treatments used on the day of survey and during the preceding six days were recorded on standardised forms. All HAIs active or under treatment on the day of survey were included. HAIs were categorised into early-onset (onset within the first 72 h of life) and late-onset (onset after the first 72 h of life) infections. During the six surveys, 1281 forms were obtained. Among them, 164 HAIs in 163 patients were identified (overall prevalence, 13%); 63 (38%) of the HAIs were late-onset infections (prevalence, 6.5%). Main types of HAI were clinical sepsis, laboratory-confirmed bloodstream infection, conjunctivitis, and pneumonia. Of all HAIs, 24% were microbiologically confirmed. Patients with birth weight <1500 g suffered from late-onset HAIs more commonly than those with birth weight > or =1500 g (10% vs 4%, P<0.01). Also hospitalisation of > or =7 days was associated with increased prevalence of HAI (8% vs 3%, P=0.01). The study was useful in terms of increasing awareness of HAI in the participating NICUs. These results can be used to strengthen incidence surveillance of HAIs in the Finnish NICUs in the future.
据报道,超过五分之一的新生儿重症监护病房 (NICU) 患者患有医疗保健相关感染 (HAI)。本研究旨在评估芬兰 NICU 患者 HAI 的患病率、发病时间和类型。我们在 2008 年 11 月至 2009 年 5 月期间在所有芬兰 NICU 中进行了六次每月的点患病率调查(N=24)。对于调查当天在场的所有患者,在标准表格上记录了调查当天和前六天使用的基础疾病和侵入性设备或治疗方法。包括调查当天活跃或正在治疗的所有 HAI。HAI 分为早发性(出生后 72 小时内发病)和晚发性(出生后 72 小时后发病)感染。在六次调查中,共获得 1281 份表格。其中,在 163 名患者中发现了 164 例 HAI(总体患病率为 13%);63 例(38%)的 HAI 为晚发性感染(患病率为 6.5%)。主要的 HAI 类型是临床败血症、实验室确认的血流感染、结膜炎和肺炎。所有 HAI 中,有 24%经微生物学证实。出生体重 <1500 g 的患者比出生体重≥1500 g 的患者更容易发生晚发性 HAI(10%比 4%,P<0.01)。住院时间≥7 天也与 HAI 患病率增加相关(8%比 3%,P=0.01)。该研究有助于提高参与 NICU 对 HAI 的认识。这些结果可用于未来加强芬兰 NICU 中 HAI 的发病率监测。