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目的了解我国三级甲等综合医院新生儿监护病房(NICU)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。方法以多中心研究的方式,选取全国9省17所医院,按照统一的诊断标准和方法对2013年10月—2014年9月NICU住院新生儿的医院感染情况进行前瞻性监测。结果共监测12 998例NICU住院新生儿,发生436例次医院感染,例次发病率为3.35%,住院总日数为126 125 d,日发病率为3.46‰。新生儿医院感染例次发病率随新生儿出生体重的增加而下降(χ2=291.55,P<0.001)。不同规模NICU新生儿医院感染发病率比较,差异有统计学意义(χ2=49.77,P<0.001),床位数>30张的NICU新生儿医院感染例次发病率和日发病率最高;NICU新生儿医院感染例次发病率以西南地区(10.36%)最高,日发病率以华南地区(10.52‰)最高。感染部位以下呼吸道和血液为主;感染病原体以肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌为主。结论我国NICU不同出生体重组、不同规模、不同地区的新生儿医院感染发病率不同,应继续加强监测,根据感染特点指导各项防控措施的落实。
Objective To understand the prevalence of nosocomial infection in neonatal intensive care unit (NICU) in Grade A general hospitals in China and provide a scientific basis for the prevention and control of neonatal nosocomial infections. Methods A multicenter study was conducted to select 17 hospitals in 9 provinces of China and prospectively monitor hospital-acquired neonatal NICU incidence from October 2013 to September 2014 according to uniform diagnostic criteria and methods. Results A total of 12,998 NICU inpatients were monitored and 436 secondary hospital infections occurred. The incidence rate was 3.35%, the total number of hospitalizations was 126 125 days, and the daily morbidity was 3.46 ‰. The incidence of neonatal nosocomial infections decreased with the increase of newborns’ birth weight (χ2 = 291.55, P <0.001). The prevalence rates of nosocomial infections among neonatal NICU of different sizes were statistically significant (χ2 = 49.77, P <0.001), and the incidence of NICOS and daily morbidity was the highest in NICU newborns with more than 30 beds. NICU neonates The incidence of nosocomial infections was highest in southwestern China (10.36%), with the highest prevalence in southern China (10.52 ‰). The main respiratory tract and blood following the site of infection; Klebsiella pneumoniae infection, Escherichia coli, Acinetobacter baumannii-based. Conclusion The prevalence of nosocomial infections in NICU with different birth weight groups, different scales and different regions are different. Monitoring should be strengthened and the implementation of various prevention and control measures should be guided according to the characteristics of infection.