Townsend T R, Wenzel R P
Am J Epidemiol. 1981 Jul;114(1):73-80. doi: 10.1093/oxfordjournals.aje.a113176.
Routine surveillance of 1252 newborns admitted over a four-year period to a newborn intensive care unit (ICU) identified 49 (4%) with nosocomial bloodstream infections. Forty-nine control subjects without such infections were selected, matching for birth weight, gestational age, and at least three diagnoses per patient. Overall, 27% of cases and 6% of controls died (p = 0.01) and significant differences persisted when cases with multiple bloodstream infections were removed from analysis. Although small numbers of case-control pairs remained for analysis, significant differences disappeared when cases with multiple bloodstream infections plus case-control pairs discordant for presence/absence of nosocomial infections at other sites were eliminated from comparison. On the average, all cases and controls were hospitalized for 70 +/- 14 days and 50 +/- 8 days, respectively, but when cases with multiple bloodstream infections or the multiple bloodstream infections-discordant pair group were removed from analysis, the significant difference in hospitalization disappeared. A strong association between nosocomial infections at sites other than the bloodstream and bloodstream infections was demonstrated and may suggest a means of reducing the incidence of bloodstream infections in a high risk population.
在四年期间入住新生儿重症监护病房（ICU）的1252名新生儿的常规监测中，发现49例（4%）患有医院血流感染。选择了49名没有此类感染的对照对象，根据出生体重、胎龄以及每位患者至少三种诊断进行匹配。总体而言，27%的病例和6%的对照死亡（p = 0.01），当将多重血流感染的病例从分析中剔除时，显著差异仍然存在。尽管用于分析的病例对照对数量较少，但当将多重血流感染的病例以及在其他部位存在/不存在医院感染不一致的病例对照对从比较中剔除时，显著差异消失。平均而言，所有病例和对照分别住院70±14天和50±8天，但当将多重血流感染的病例或多重血流感染不一致对组从分析中剔除时，住院时间的显著差异消失。血流以外部位的医院感染与血流感染之间存在强烈关联，这可能提示了一种降低高危人群血流感染发生率的方法。
