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埃及一家三级医院新生儿重症监护病房的医疗保健相关感染监测:1年随访

Surveillance of health care-associated infections in a tertiary hospital neonatal intensive care unit in Egypt: 1-year follow-up.

作者信息

Gadallah Mohsen Abdel Hamid, Aboul Fotouh Aisha Mohamed, Habil Ihab Shehad, Imam Safaa Shafik, Wassef Ghada

机构信息

Department of Community Medicine, Ain Shams Faculty of Medicine, Cairo, Egypt.

Department of Community Medicine, Ain Shams Faculty of Medicine, Cairo, Egypt.

出版信息

Am J Infect Control. 2014 Nov;42(11):1207-11. doi: 10.1016/j.ajic.2014.07.020. Epub 2014 Sep 16.

Abstract

BACKGROUND

Reported rates of neonatal health care-associated infections (HAIs) in neonatal intensive care units (NICUs) have risen rapidly in recent years. Little data are available in Egypt, however. The aim of the present study was to determine the incidence of and risk factors for HAIs in the NICU of Ain Shams University Hospital of Obstetrics and Gynecology.

METHODS

A prospective study was carried out on all neonates admitted in the NICU of Ain Shams University Hospital of Obstetrics and Gynecology in 2012. Centers for Disease Control and Prevention criteria were followed for identifying HAIs.

RESULTS

A total of 434 neonates were enrolled in the study. The cumulative incidence of HAIs in the NICU was 28%. Bloodstream infections accounted for 85% of HAI episodes; pneumonia, for 10%. The most common organism isolated was Klebsiella spp. The main risk factors identified on multivariable analysis were gestational age <38 weeks (relative risk [RR], 1.63), birth weight <1,500 g (RR, 1.39), mechanical ventilation (RR, 1.74), and surgical procedures (RR, 1.65). The mortality rate attributed to HAIs was 11.75%, and the extra hospital length of stay attributed to HAIs was 8 days.

CONCLUSION

The high incidence of HAI identified in the study NICU mandates more vigorous infection control interventions.

摘要

背景

近年来,新生儿重症监护病房(NICU)中报告的新生儿医疗保健相关感染(HAIs)发生率迅速上升。然而,埃及的相关数据很少。本研究的目的是确定艾因夏姆斯大学妇产科医院NICU中HAIs的发生率及危险因素。

方法

对2012年入住艾因夏姆斯大学妇产科医院NICU的所有新生儿进行了一项前瞻性研究。采用疾病控制与预防中心的标准来识别HAIs。

结果

共有434名新生儿纳入本研究。NICU中HAIs的累积发生率为28%。血流感染占HAI发作的85%;肺炎占10%。分离出的最常见病原体是克雷伯菌属。多变量分析确定的主要危险因素为胎龄<38周(相对危险度[RR],1.63)、出生体重<1500 g(RR,1.39)、机械通气(RR,1.74)和外科手术(RR,1.65)。HAIs导致的死亡率为11.75%,HAIs导致的额外住院天数为8天。

结论

本研究NICU中确定的HAI高发生率要求采取更有力的感染控制干预措施。

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