新生儿医疗相关结膜炎的发病率、病因及危险因素：来自印度一家三级医疗医院的前瞻性研究
Incidence, Etiology and Risk Factors Associated with Neonatal Healthcare-Associated Conjunctivitis: A Prospective Study from a Tertiary Care Hospital in India.
作者信息
Goel Kanika, Randhawa Valinderjeet Singh, Saili Arvind, Khare Shashi, Kumar Ajay, Dutta Renu, Goel Gaurav
机构信息
Department of Microbiology, Lady Hardinge Medical College and associated Smt. Sucheta Kriplani Hospital, New Delhi, 110001, India Department of Medicine, University of Kentucky, KY 40536, USA
Department of Microbiology, Lady Hardinge Medical College and associated Smt. Sucheta Kriplani Hospital, New Delhi, 110001, India.
出版信息
J Trop Pediatr. 2016 Feb;62(1):10-8. doi: 10.1093/tropej/fmv064. Epub 2015 Oct 1.
INTRODUCTION
Healthcare-associated conjunctivitis (HAC) can lead to serious sequelae including blindness. We conducted a one-year prospective study to determine the epidemiology of neonatal HAC at a tertiary-care hospital in India.
METHODS
From the neonates fulfilling a set of predefined inclusion criteria, cases of HAC were diagnosed based on CDC guidelines. Conjunctival swabs, obtained from neonates with suggestive clinical signs, were processed using standard protocols. Twenty-eight potential risk factors were analyzed.
RESULTS
We detected 24 cases of HAC among 591 enrolled neonates, with Escherichia coli being the most frequently isolated microorganism. On multivariate analysis, intubation at birth (p = 0.046) and orogastric feeding (p = 0.029) had a statistically significant association with neonatal HAC. Average hospitalization increased from 9.6 to 20.8 days for neonates diagnosed with HAC.
CONCLUSION
A standardized case-definition and physician awareness of potential serious sequelae would help improve detection rates and timely institution of therapy. Hand hygiene could help control the menace of neonatal HAC.
引言
医疗保健相关的结膜炎（HAC）可导致包括失明在内的严重后遗症。我们在印度一家三级医疗医院进行了为期一年的前瞻性研究，以确定新生儿HAC的流行病学情况。
方法
从符合一组预定义纳入标准的新生儿中，根据美国疾病控制与预防中心（CDC）的指南诊断HAC病例。从有提示性临床体征的新生儿中获取结膜拭子，按照标准方案进行处理。分析了28个潜在风险因素。
结果
在591名登记的新生儿中，我们检测到24例HAC病例，其中大肠杆菌是最常分离出的微生物。多因素分析显示，出生时插管（p = 0.046）和经口胃管喂养（p = 0.029）与新生儿HAC有统计学上的显著关联。诊断为HAC的新生儿平均住院时间从9.6天增加到20.8天。
结论
标准化的病例定义以及医生对潜在严重后遗症的认识将有助于提高检出率并及时进行治疗。手部卫生有助于控制新生儿HAC的威胁。
Zotero 插件