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新生儿经外周中心静脉置管相关血流感染的危险因素分析:对护理的启示。

Analysis of risk factors of PICC-related bloodstream infection in newborns: implications for nursing care.

机构信息

Department of Nursing, Children's Hospital, School of Medicine, Zhejiang University, No. 3333 Binsheng Road, Binjiang District, Hangzhou City, Zhejiang Province, China.

出版信息

Eur J Med Res. 2021 Jul 23;26(1):80. doi: 10.1186/s40001-021-00546-2.

Abstract

BACKGROUND

It is necessary to analyze the characteristics and risk factors of catheter-related bloodstream infection (CRBSI) in newborns with peripherally inserted central catheter (PICC).

METHODS

Newborns undergoing PICC catheterization in the neonatal department of our hospital from January 1, 2020 to January 31, 2021 were included. The characteristics of newborns with and without CRBSI newborns were compared and analyzed. Logistic regression analyses were performed to evaluate the risk factors of CRBSI in newborns with PICC.

RESULTS

Three hundred eighty-six newborns with PICC were included, of whom 41 newborns had the CRBSI, the incidence of CRBSI in newborns with PICC was 10.62%. There were significant differences regarding the birth weight, durations of PICC stay, 5-min Apgar score, site of PICC insertion of PICC between CRBSI and no CRBSI group (all P < 0.05), and there were no significant differences regarding the gender, gestational age, cesarean section, mechanical ventilation and length of hospital stay between CRBSI and no CRBSI group (all P > 0.05). Escherichia coli (26.08%) and Staphylococcus aureus (23.92%) were the most common CRBSI pathogens in newborns with PICC. Logistic regression analysis indicated that birth weight ≤ 1500 g (OR 1.923, 95% CI 1.135-2.629), durations of PICC stay ≥ 21 days (OR 2.077, 95% CI 1.024-3.431), 5-min Apgar score ≤ 7 (OR 2.198, 95% CI 1.135-3.414) and femoral vein insertion of PICC (OR 3.044, 95% CI 1.989-4.306) were the independent risk factors of CRBSI in neonates with PICC (all P < 0.05).

CONCLUSION

For newborns with low birth weight, longer durations of PICC stay and femoral vein PICC insertion, they may have higher risks of CRBSI, and medical staff should take targeted measures to reduce the development of CRBSI.

摘要

背景

有必要分析外周静脉置入中心静脉导管(PICC)新生儿导管相关性血流感染(CRBSI)的特征和危险因素。

方法

纳入我院新生儿科 2020 年 1 月 1 日至 2021 年 1 月 31 日期间行 PICC 置管的新生儿,比较分析发生 CRBSI 的新生儿与未发生 CRBSI 新生儿的特征,并采用 Logistic 回归分析评估 PICC 新生儿 CRBSI 的危险因素。

结果

共纳入 386 例行 PICC 置管的新生儿,其中 41 例发生 CRBSI,CRBSI 发生率为 10.62%。CRBSI 组与非 CRBSI 组新生儿的出生体质量、PICC 留置时间、5 分钟 Apgar 评分、PICC 置管部位比较,差异均有统计学意义(均 P<0.05),两组新生儿的性别、胎龄、剖宫产、机械通气、住院时间比较,差异均无统计学意义(均 P>0.05)。PICC 新生儿 CRBSI 最常见的病原菌为大肠埃希菌(26.08%)和金黄色葡萄球菌(23.92%)。Logistic 回归分析结果显示,出生体质量≤1500 g(OR=1.923,95%CI 1.135-2.629)、PICC 留置时间≥21 d(OR=2.077,95%CI 1.024-3.431)、5 分钟 Apgar 评分≤7 分(OR=2.198,95%CI 1.135-3.414)、股静脉置管(OR=3.044,95%CI 1.989-4.306)是 PICC 新生儿 CRBSI 的独立危险因素(均 P<0.05)。

结论

对于低出生体质量、PICC 留置时间长、股静脉置管的新生儿,其发生 CRBSI 的风险可能较高,医务人员应采取针对性措施降低 CRBSI 的发生风险。

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