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2008 年土耳其新生儿重症监护病房的医源性感染:发生率和危险因素,一项前瞻性研究。

Healthcare-associated infections in a neonatal intensive care unit in Turkey in 2008: incidence and risk factors, a prospective study.

机构信息

Cukurova University Medical Faculty, Department of Pediatrics, Division of Neonatology, Adana, Turkey.

出版信息

J Trop Pediatr. 2011 Jun;57(3):157-64. doi: 10.1093/tropej/fmq060. Epub 2010 Jul 3.

Abstract

In this study, we have prospectively recorded healthcare-associated infections (HAIs) in NICU and found incidence density as 18 infections per 1000 patient days. Of the infections, 51.3% was bacteriemia (BSI), and 45.1% was ventilator-associated pneumonia (VAP). Gram-negative microorganisms were predominant in VAP and Staphylococcus epidermidis was the leading microorganism (53.0% of BSIs) in BSIs. Multivariate logistic regression analysis showed the importance of hood O(2) use in days (RR: 1.3) and total parenteral nutrition use in days (RR: 1.09) for BSIs. Umbilical arterial catheterization in days (RR: 1.94), ventilator use in days (RR: 1.05), chest tube (RR: 12.55), orogastric feeding (RR: 3.32) and total parenteral nutrition in days (RR: 1.05) were found to be significantly associated with VAP. In conclusion, incidence density in our unit is high and Gram-negative rods are predominant similar to developing countries. These results strongly suggest improving measures of prevention and control of HAIs in the unit.

摘要

在本研究中,我们前瞻性地记录了新生儿重症监护病房(NICU)的医源性感染(HAI),发现感染发病率密度为每 1000 个患者日 18 例。其中,51.3%为菌血症(BSI),45.1%为呼吸机相关性肺炎(VAP)。革兰氏阴性微生物在 VAP 中占主导地位,表皮葡萄球菌是 BSI 中主要的微生物(53.0%的 BSI)。多变量逻辑回归分析表明, hood O(2) 使用天数(RR:1.3)和全胃肠外营养使用天数(RR:1.09)对 BSI 很重要。脐动脉置管天数(RR:1.94)、呼吸机使用天数(RR:1.05)、胸腔引流管(RR:12.55)、鼻胃管喂养(RR:3.32)和全胃肠外营养使用天数(RR:1.05)与 VAP 显著相关。总之,我们单位的发病率密度较高,革兰氏阴性杆菌占主导地位,与发展中国家相似。这些结果强烈提示应改善该单位的 HAI 预防和控制措施。

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