细菌定植与新生儿感染。新生儿重症监护室中皮肤和脐带消毒的效果。

Bacterial colonization and neonatal infections. Effects of skin and umbilical disinfection in the nursery.

作者信息

Meberg A, Schøyen R

出版信息

Acta Paediatr Scand. 1985 May;74(3):366-71. doi: 10.1111/j.1651-2227.1985.tb10985.x.

DOI:10.1111/j.1651-2227.1985.tb10985.x

Abstract

In a prospective randomized study different regimens for skin and umbilical disinfection in newborn infants were tested: daily whole body soap wash (control group), daily whole body soap wash and umbilical cleansing with (i) benzine solution, or (ii) 0.05% chlorhexidine, and daily whole body wash and umbilical cleansing with a 4% chlorhexidine detergent solution (Hibiscrub). Bacterial cultures were taken from the nose and umbilical area at discharge. Clinical infections were registered in the nursery, and after discharge until 6 weeks of age. Cultures were taken from infected areas. In the control group a high colonization rate was found for S. aureus (91%), E. coli (39%), and group B streptococci (GBS) (20%). The colonization rates were influenced by the Hibiscrub regimen (colonization rate for S. aureus 59%, E. coli 23%, and GBS 10%), but not by the other regimens. Infections (pemphigus, paronychia, conjunctivitis, umbilical infection) occurred in 12.9% of the infants, of whom 65% got infection after discharge from the nursery. 96% of the infections were caused by S. aureus, and 87% caused by strains colonizing the infants in the nursery. None of the tested regimens reduced the rate of infections during the first 6 weeks of life.

摘要

在一项前瞻性随机研究中，对新生儿皮肤和脐带消毒的不同方案进行了测试：每日全身用肥皂清洗（对照组），每日全身用肥皂清洗且脐带用（i）汽油溶液或（ii）0.05%氯己定进行清洁，以及每日全身清洗且脐带用4%氯己定洗涤剂溶液（洗必泰醇）进行清洁。在出院时从鼻子和脐带部位采集细菌培养样本。在婴儿室记录临床感染情况，并在出院后直至6周龄进行记录。从感染部位采集培养样本。在对照组中，发现金黄色葡萄球菌的定植率很高（91%），大肠杆菌为39%，B组链球菌（GBS）为20%。定植率受洗必泰醇方案的影响（金黄色葡萄球菌定植率为59%，大肠杆菌为23%，GBS为10%），但不受其他方案的影响。12.9%的婴儿发生了感染（脓疱病、甲沟炎、结膜炎、脐带感染），其中65%在从婴儿室出院后发生感染。96%的感染由金黄色葡萄球菌引起，87%由在婴儿室定植于婴儿的菌株引起。所测试的方案均未降低出生后前6周的感染率。