陕西省某医院2014—2017 年 新生儿医院内感染分析

Analysis of neonatal nosocomial infections in hospital of Shaanxi province in recent 4 years

摘要:

目的 探讨陕西省某医院新生儿科医院感染的流行特点，为预防和控制新生儿医院感染提供科 学依据。方法 回顾性分析2014 年1 月—2017 年12 月入住陕西省人民医院新生儿科的患儿，收集在住院期 间发生医院感染的患儿临床资料，对数据进行分析。结果 近4 年来共监测新生儿9 634 例，其中发生院内感 染328 例，院内感染例次为332 例，2014—2017 年医院感染（NI）发生率比较，差异无统计学意义（P >0.05）。 近4 年日感染率为5.51‰，发生导管相关血流感染率为6.00‰，2014—2017 年导管相关血流感染率比较，差异 无统计学意义（P >0.05）。呼吸机使用时间为1 078 d，呼吸机相关肺炎发生率为19.48‰ ；2014—2017 年呼吸 机相关肺炎感染率比较，差异无统计学意义（P >0.05）；医院感染部位以血液相关感染居首位，其次为呼吸道 感染，2014—2017 年胃肠道感染、呼吸道感染及其他部位感染率比较，差异有统计学意义（P <0.05）。不同 出生体重患儿NI 发生率比较，差异有统计学意义（P <0.05）。2014—2017 年每个季度的NI 发生率比较，差 异无统计学意义（P <0.05）。结论 陕西省人民医院新生儿科医院感染控制效果尚可，但仍需加强院感监控； 重点应预防极低出生体重组和血液相关感染，采取针对性的预防控制措施，减少医院内感染的发生。

Abstract:

Objective To investigate the epidemiological characteristics of healthcare associated infection (HAI) in neonatal units and provide scientific evidence for the prevention and control of neonatal HAI. Methods A retrospective analysis was made on the children admitted to the neonatal department of Shaanxi People's Hospital from January 2014 to December 2017. The clinical data of the children with nosocomial infection during hospitalization were collected and analyzed. Results From January 2014 to December 2017, we enrolled 9 634 neonates cases in Department of Neonatology, Shaanxi Province People’s Hospital. There were 328 cases having nosocomial infections. There was no significant difference in NI incidence from 2014 to 2017 (P > 0.05). In recent 4 years, the infection rate was 5.51 and the incidence of catheter-related blood flow infection was 6.00. There was no significant difference in the incidence of catheter-related blood flow infection from 2014 to 2017 (P > 0.05). The duration of ventilator use was 1078 days, and the incidence of ventilator-associated pneumonia was 19.48. There was no significant difference in the infection rate of ventilator-associated pneumonia from 2014 to 2017 (P > 0.05). Blood-related infection was the most common site of nosocomial infection, followed by respiratory infection. The infection rates of gastrointestinal tract, respiratory tract and other sites from 2014 to 2017 were significantly different (P < 0.05). There was significant difference in NI incidence among children with different birth weight (P < 0.05). There was no significant difference in the incidence of NI in each quarter between 2014 and 2017 (P < 0.05). Conclusions The control effect of nosocomial infection in the Department of Neonatology of Shaanxi People's Hospital is still acceptable, but the monitoring of nosocomial infection still needs to be strengthened. The focus should be on the prevention of very low birth weight group and blood-related infections and the adoption of targeted preventive and control measures to reduce the incidence of nosocomial infections.