Goldmann D A, Durbin W A, Freeman J
J Infect Dis. 1981 Nov;144(5):449-59. doi: 10.1093/infdis/144.5.449.
Based on five years of surveillance in a neonatal intensive care unit (NICU), host and therapeutic risk factors for nosocomial infection were determined and the impact of staffing and environment on the rate of nosocomial infection was evaluated. From January 1974 to February 1977, infants occupied a crowded, hectic NICU that lacked basic infection control features, and 5.2% of the infants had at least one major nosocomial infection. The risk of nosocomial infection was associated with low birth weight, patent ductus arteriosus, surgery, and multiple supportive measures. After a new NICU opened in February 1977, 0.9% of the patients had major nosocomial infections (relative risk [old nursery/new nursery] = 5.06; P less than 10(-5); 95% confidence interval, 2.62-9.73). Improvements included 50% more nurses, increased space per infant, convenient sinks, and isolation facilities. Host and therapeutic risk factors for nosocomial infections were comparable in the old and new nurseries. The decrease in the rate of nosocomial infections therefore appeared to be due to improved staffing and environment.
基于在新生儿重症监护病房（NICU）进行的五年监测，确定了医院感染的宿主和治疗风险因素，并评估了人员配备和环境对医院感染率的影响。1974年1月至1977年2月，婴儿入住了一个拥挤、繁忙且缺乏基本感染控制设施的NICU，5.2%的婴儿至少发生过一次严重医院感染。医院感染风险与低出生体重、动脉导管未闭、手术以及多种支持措施有关。1977年2月新的NICU启用后，0.9%的患者发生了严重医院感染（相对风险[旧病房/新病房]=5.06；P<10^(-5)；95%置信区间，2.62 - 9.73）。改进措施包括护士人数增加50%、每个婴儿的空间增大、配备便利的水槽以及隔离设施。新旧病房中医院感染的宿主和治疗风险因素相当。因此，医院感染率的下降似乎是由于人员配备和环境的改善。
