论文部分内容阅读
目的分析本院新生儿NICU早产儿院内感染败血症病原学特点及临床特点,高危因素,探讨早产儿感染的相关因素,为防治提供措施。方法对2009年1月-2012年6月收住本院NICU治疗的2 940例早产儿中的47例院内感染败血症的临床资料、病原菌、高危因素及治疗预后进行回顾性分析。结果早产儿院内感染败血症发生率占住院早产儿的1.6%,早产儿占院内感染的75%。病原菌中革兰阴性菌占53.1%,以肺炎克雷伯氏菌为主,大肠埃希菌-B内酰胺酶次之;革兰阳性菌占36.3%,凝固酶阴性的表皮葡萄球菌为主;真菌占10.6%,以念珠菌为主。药敏结果显示大肠埃希菌-耐B内酰胺酶、肺炎克雷伯菌对亚胺培南、哌拉西林他唑巴坦敏感率分别为100.0%;凝固酶阴性的表皮葡萄球菌MRCNS阳性对万古霉素敏感率为100.0%,真菌对氟康唑等常用抗真茵药均敏感。结论加强护理、严格无菌操作、合理使用抗生素及预防性抗真菌治疗,加强支持治疗,增强免疫力,是减少院内感染败血症及其并发症的发生的重要措施。
Objective To analyze the etiological characteristics, clinical features and risk factors of nosocomial sepsis in neonates with NICU premature infants in our hospital and explore the related factors of premature infants in order to provide measures for prevention and treatment. Methods The clinical data, pathogens, high risk factors and prognosis of 47 cases of nosocomial sepsis in 2940 preterm infants admitted to NICU in our hospital from January 2009 to June 2012 were analyzed retrospectively. Results The incidence of nosocomial sepsis in preterm infants accounted for 1.6% of preterm infants and preterm infants accounted for 75% of nosocomial infections. Gram-negative bacteria accounted for 53.1% of pathogens, mainly Klebsiella pneumoniae, Escherichia coli-B lactamase followed; Gram-positive bacteria accounted for 36.3%, coagulase-negative Staphylococcus epidermidis-based; Fungus accounted for 10.6%, mainly Candida. The susceptibility results showed that the susceptibilities of Escherichia coli-resistant B lactamase and Klebsiella pneumoniae to imipenem and piperacillin-tazobactam were 100.0%, respectively; coagulase negative Staphylococcus epidermidis MRCNS positive The susceptibility of vancomycin was 100.0%. The fungi were sensitive to commonly used antifungal agents such as fluconazole. Conclusion Strengthening nursing, strict aseptic operation, rational use of antibiotics and prophylactic antifungal therapy, strengthening supportive treatment and enhancing immunity are important measures to reduce the incidence of sepsis and its complications in hospital.