Decembrino L, Perrini S, Stronati M
Neonatologia, Patologia Neonatale, Terapia Intensiva, Fondazione IRCCS Policlinico San Matteo, Pavia.
Minerva Pediatr. 2010 Jun;62(3 Suppl 1):41-5.
Nosocomial infections are one of the major causes of morbidity and mortality in the newborn intensive care unit (NICU). They result in prolonged hospital stays and increased hospital costs. Neonates are susceptible hosts because of prematurity of organ systems, immaturity of immune system, low birth weight and the use of invasive devices. Most infections are endemic others can occur during outbreaks. As advances in medical technology improve mortality in the tiniest of infants, it is imperative that health care providers identify effective interventions to minimize the risks of nosocomial infections in the NICU. Recommended infection control and prevention strategies are: hand washing promotion, decreased use of invasive procedures, limited antitibiotic exposure, environmental hygiene. In this context infection surveillance is the first step to recognize and analyze problems, to effectively target infection control measures and feedback. Any suspicion of an outbreak should lead to a review of general infection control procedures to prevent the spread of the pathogens as quickly as possible. A multidisciplinary approach can be an effective means of developing a plan of action to apply prolonged and strict adherence to isolation precautions', to detect potential reservoirs or source of infections, to educate every member of the patient care team and to review NICU protocols.
医院感染是新生儿重症监护病房（NICU）发病和死亡的主要原因之一。它们导致住院时间延长和医院成本增加。由于器官系统不成熟、免疫系统不成熟、低出生体重以及使用侵入性设备，新生儿是易感宿主。大多数感染是地方性的，其他感染可能在暴发期间发生。随着医疗技术的进步提高了最小婴儿的死亡率，医疗保健提供者必须确定有效的干预措施，以尽量降低NICU中医院感染的风险。推荐的感染控制和预防策略包括：促进洗手、减少侵入性操作的使用、限制抗生素暴露、环境卫生。在这种情况下，感染监测是识别和分析问题、有效针对感染控制措施和反馈的第一步。任何对暴发的怀疑都应导致对一般感染控制程序的审查，以尽快防止病原体传播。多学科方法可能是制定行动计划的有效手段，以长期严格遵守隔离预防措施，检测潜在的感染源或感染源头，对患者护理团队的每个成员进行教育，并审查NICU的方案。
