Cukurova University Medical Faculty, Department of Pediatrics, Division of Neonatology, Adana, Turkey.
J Trop Pediatr. 2011 Jun;57(3):157-64. doi: 10.1093/tropej/fmq060. Epub 2010 Jul 3.
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.
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。
