OBJECTIVE: To investigate the main risk factors and pathogen distribution of nosocomial sepsis among premature infants. METHODS: The clinical data of 3418 hospitalized premature infants from January 2003 to December 2010 were retrospectively analyzed for the risk factors and pathogen distribution of nosocomial sepsis. RESULTS: The incidence of neonatal nosocomial sepsis was 3.10% (106/3418), and the median age at diagnosis of neonatal nosocomial sepsis was 19 (4-48) days. The major pathogens of the infections among these premature infants included gram-positive bacteria (45.2%), especially coagulase-negative Staphylococcus (24.3%), and gram-negative bacteria (41.7%), especially Klebsiella pneumoniae (25.2%), as well as fungus (13.0%). Logistic regression analysis showed that the main risk factors included low birth weight, retention of central venous catheters, and long duration of parenteral nutrition (OR: 3.765, 3.051, and 2.998, respectively; P<0.05). CONCLUSIONS: Low birth weight, retention of central venous catheters, and long duration of parenteral nutrition are the main risk factors for neonatal nosocomial sepsis, whereas the leading pathogen is Klebsiella pneumoniae.
Key words
Nosocomial infection /
Sepsis /
Risk factor /
Premature infant
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
［1］童笑梅，王新利，诸慧华，张雪峰，关立兰.12年早产儿院内感染的临床分析［J］．中华围产医学杂志，2004，7（5）：279-282.
［2］张舒，王琍琍. 早产儿医院感染危险因素分析及预防对策［J］．安徽医科大学学报，2011，46（6）：595-597.
［3］中华医学会儿科学分会新生儿组，《中华儿科杂志》编辑委员会．新生儿败血症诊疗方案［J］．中华儿科杂志，2003，41（12）：897-899.
［4］中华人民共和国卫生部.医院感染管理规范［S］.北京：中华人民共和国卫生部，2001：28-29.
［5］姜毅.新生儿败血症诊疗新进展［J］．中国新生儿科杂志，2010，25（2）：65-72.
［6］Salamati P, Rahbarimanesh AA, Yunesian M, Naseri M. Neonatal nosoeomial infections in Bahrami Children Hospital［J］.Indian J Pediatr, 2006, 73(3): 197-200.
［7］Couto RC, Carvalho EA, Pedrosa TM, Pedroso ER, Neto MC, Biscione FM. A 10-year prospective surveillance of nosocomial infections in neonatal intensive care units［J］.Am J Infect Control, 2007, 35(3): 183-189.
［8］Perlman SE, Saiman L, Larson EL. Risk factors for late-onset health care-associateed bloodstream infections in patients in neonatal intensive care units［J］. Am J Infect Control, 2007, 35(3): 177-182.
［9］Downey LC, Smith PB, Benjamin DK Jr. Risk factors and prevention of late-onset sepsis in premature infants［J］.Early Hum Dev, 2010, 86(Suppl 1):7-12.
［10］Geffers C, Baerwolff S, Schwab F, Gastmeier P.Incidence of health care-associated infections in high-risk neonates: results from the German surveillance system for very-low-birthweight infants［J］. J Hosp Infect, 2008, 68(3): 214-221.
［11］Smith PB, Benjamin DK Jr, Cotten CM, Schultz E, Guo R, Nowell L, et al. Is an increased dwell time of a peripherally inserted catheter associated with increased infection risk of bloodstream infection in infants?［J］. Infect Control Hosp Epidemiol, 2008, 29(8):749-753.
［12］Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, et al. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network［J］. Pediatrics, 2002, 110(2 pt 1): 285-291.
［13］徐发林，李文丽，冯中静，邢秋景，程秀永. 早产儿细菌感染病原菌分布及10年变迁［J］．实用儿科临床杂志，2008，23（14）：1071-1073.
［14］Long SS, Stevenson DK. Reducing Candida infections during neonatal intensive care:management choices, infection control,and fluconazole prophylaxis［J］.J Pediatr, 2005, 147(2): 135-141.
［15］费淑兰.早产儿医院感染败血症临床特点与病原学分析［J］．中国当代儿科杂志，2009，11（2）：146-148.
［16］Manzoni P, Mostert M, Jacqz-Aiqrain E, Farina D.The use of fluconazole in neonatal intensive care units［J］. Arch Dis Child, 2009, 94(12):983-987.
［17］Pappas PG, Kauffman CA, Andes D, Benjamin DK Jr, Calandra TF, Edwards JE Jr, et al. Clinical practice guidelines for the management of candidiasis:2009 update by the Infectious Diseases Society of America［J］.Clin Infect Dis, 2009, 48(5): 503-535.
PDF(975 KB)
