目的 分析早产儿院内细菌感染败血症可能的主要危险因素和病原菌分布,为临床治疗提供科学依据。方法 选取2008年5月-2017年4月本院收治的87例院内细菌感染败血症的早产儿作为研究对象,对其发生院内细菌感染败血症的危险因素及病原菌进行分析。结果 早产儿院内细菌感染败血症的发生率为1.20%(87/7 221)。感染病原菌中革兰阳性菌占70.8%,主要为表皮葡萄球菌 (33.3%) ;革兰阴性菌占29.2%,主要为肺炎克雷伯杆菌(42.3%) 。Logistic回归分析结果显示,极低出生体重(OR=1.9,95%CI:0.9~5.3,P=0.013)、留置经外周静脉置入的中心静脉导管(PICC)(OR=3.3,95%CI:2.5~8.3,P=0.006)、气管插管(OR=2.3,95%CI:1.7~5.7,P=0.001)和双胎(OR=1.5,95%CI:0.7~4.2,P=0.009)是早产儿院内细菌感染败血症的危险因素。结论 表皮葡萄球菌是早产儿院内细菌感染败血症的主要病原菌;极低出生体重、留置经外周静脉置入的中心静脉导管、气管插管和双胎是早产儿院内细菌感染败血症的危险因素。
Abstract
Objective To investigate the main risk factors and pathogen distribution of preterm infants with nosocomial bacterial sepsis. Methods Totally 87 preterm infants with nosocomial bacterial septicemia from the Neonatology Department of the Maternal and Child Health Hospital Affiliated to Nanjing Medical University were recruited from May,2008 to April,2017.High risk factors and pathogens of sepsis were analyzed. Results The prevalence of preterm infants with nosocomial bacterial sepsis was 1.20%(87/7 221).The major pathogens of the infections among these premature infants included gram-positive bacteria(70.8%),especially staphylococcus epidermidis(33.3%),and gram-negative bacteria (29.2%),especially Klebsiella pneumoniae (42.3%).Logistic regression analysis showed that the very low birth weight(OR=1.9,95%CI:0.9~5.3,P=0.013),indwelling peripherlly inserted central catheter (PICC)(OR=3.3,95%CI:2.5~8.3,P=0.006),tracheal intubation (OR=2.3,95%CI:1.7~5.7,P=0.001) and twins (OR=1.5,95%CI:0.7~4.2,P=0.009) were high risk factors of preterm infants with nosocomial bacterial sepsis. Conclusion The very low birth weight,indwelling PICC,tracheal intubation and twins are high risk factors of neonates with nosocomial bacterial sepsis,whereas the leading pathogen is staphylococcus epidermidis.
关键词
早产儿 /
院内感染 /
败血症 /
高危因素
Key words
preterm infants /
nosocomial infection /
septicemia /
risk factor
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基金
江苏省卫计委妇幼健康科研项目(F201639);无锡市卫计委妇幼健康科研项目(FYKY201601);无锡市“科教强卫工程”项目(ZDXK003、QNRC039)
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