住院早产儿医院感染临床剖析.docVIP

住院早产儿医院感染临床剖析 　　【摘要】目的 探讨早产儿医院感染发生率（院感率）的相关高危因素，揭示其病原学特点，指导临床工作。方法 对869例早产儿的临床相关资料进行调查、登记和分析，总结早产儿医院感染（院感）与出生体重、住院天数的关系，分析其病原体和耐药情况。结果 869例早产儿院感率为3.6%，其中101例极低出生体重（VLBW）儿院感率10.9%，768例低出生体重（LBW）儿院感率2.6%?；足月儿院感率仅0.7%；早产儿院感多发生在住院的第2~3周，VLBW儿院感多发生在第3周，LBW儿院感多发生在第2周；早产儿院感以下呼吸道感染最多见，其次为皮肤黏膜感染；病原体大多数是革兰氏阴性（G-）杆菌，其中肺炎克雷伯杆菌肺炎亚种高达57.1%，产ESBL酶杆菌和MRSA葡萄球菌达80.0%。结论 早产儿尤其VLBW儿易发生院感，住院后2~3周内出现呼吸道感染多见，病原菌以耐药G-杆菌（肺炎克雷伯杆菌肺炎亚种）为主，临床上应高度注意，防止其在新生儿病室暴发传播。 　　【关键词】医院感染；早产儿；病原学；耐药性 　　 　　A Clinical Analysis of Hospitalized Premature Neonates Nosocomial Infection FAN Yan-zhou,XIAO Zheng xiang.(Department of Pediatrics, Zhuzhou Peoples Hospital Department of Pediatrics, Zhuzhou Affiliated Hospital, Changsha Medical College, Zhuzhou, 412000, China) 　　【Abstract】Objectives To probe the factors that cause the infection of the hospitalized premature neonates and reveal the features of its etiological features and therefore provide a guideline for the clinical practice.Methods By investigating, and screening the documents of 869 hospitalized premature neonates, the paper tries to establish and identify the relationship between the rate of their infection and their weight at birth and the days in hospital, and make a systematic analysis of their specific pathogens and drug tolerance. Results The research reveals that 3.6% of the 869 premature neonates developed hospital infection. 10.9% of 101 premature neonates with very low birth weight (VLBW) developed infection,and 2.6% of 768 premature neonates with low birth weight (LBW) developed infection, while the rate of hospitalized mature neonates is only 0.7%. Most cases of hospital infection occurred in the second or third week. Premature neonates with VLBW were often infected in their third week., and premature neonates with LBW in their second week. The hospital infection of premature neonates was characterized by the infection of low respiratory tract and second skin or membrane. Most of the infectious pathogens are the subspecies of Gram-neg