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新生儿重症监护病房医院感染的流行病学

[Epidemiology of nosocomial infections in a neonatal intensive care unit].

作者信息

García Heladia, Martínez-Muñoz Angeles Nahima, Peregrino-Bejarano Leoncio

机构信息

Unidad de Cuidados Intensivos Neonatales, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2014;52 Suppl 2:S30-7.

Abstract

BACKGROUND

Newborns who are admitted to neonatal intensive care units are at a high risk for the development of a nosocomial infection. The purpose of this study was to record the incidence and the type of nosocomial infections, the isolated microorganisms and the susceptibility profile of these newborns in a neonatal intensive care unit.

METHODS

A descriptive, prospective, longitudinal study was conducted over a 1-year period. Out of 113 newborns with nosocomial infection, demographic variables, antibiotic use prior to admission, central venous catheter use, type of nosocomial infection, isolated microorganism and susceptibility profile were recorded.

RESULTS

One hundred and forty nine nosocomial infection episodes were recorded, with an incidence of 37.7 × 100 discharges and an incidence density rate of 25.6 × 1000 patient-days. The most common nosocomial infections were central venous catheter colonization related bacteremia (35.5 %) and sepsis (28.8 %). The most common microorganisms were coagulase-negative Staphylococcus (43.4 %) and Klebsiella pneumoniae (21 %), out of which 97.3 % were extended-spectrum beta-lactamase-producers.

CONCLUSIONS

The incidence of nosocomial infection was similar to that reported in developing countries. Central venous catheter colonization-related bacteremia and gram-positive bacteria were the most common nosocomial infection and causative microorganisms, respectively.

摘要

背景

入住新生儿重症监护病房的新生儿发生医院感染的风险很高。本研究的目的是记录一家新生儿重症监护病房中这些新生儿医院感染的发生率、类型、分离出的微生物以及药敏情况。

方法

进行了一项为期1年的描述性、前瞻性纵向研究。记录了113例医院感染新生儿的人口统计学变量、入院前抗生素使用情况、中心静脉导管使用情况、医院感染类型、分离出的微生物及药敏情况。

结果

记录到149例医院感染事件,发生率为37.7×100次出院,发病密度率为25.6×1000患者日。最常见的医院感染是中心静脉导管定植相关菌血症(35.5%)和败血症(28.8%)。最常见的微生物是凝固酶阴性葡萄球菌(43.4%)和肺炎克雷伯菌(21%),其中97.3%是产超广谱β-内酰胺酶的菌株。

结论

医院感染发生率与发展中国家报道的相似。中心静脉导管定植相关菌血症和革兰氏阳性菌分别是最常见的医院感染和致病微生物。

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