Nosocomial Infection Investigation And Risk Factors In Neonatal Intensive Care Unit

Objective:To investigate the prevalence of infection in neonatal intensive care unit of Dalian children's,understand the infection route of nosocomial infection ? the main pathogens and drug sensitive situation,investigation and analyse the risk factors of nosocomial infection,to prevent and reduce the nosocomial infection in newborn wards.Methods:A total of 3600 newborns were enrolled in the neonatal intensive care unit of Dalian children's Hospital,Among them 55 newborns with nosocomial infections were included in the infection group with reference to the hospital acquired infection,3545 cases were found without neonatal nosocomial infection as the investigated parameters include the non infection group.The parameters include the general clinical data of the newborns(gender?gestational age?birth weight?Apgar score?mode of delivery?admission time?antibiotic use before infection and with or without history of asphyxia)and Mothers(parity ? treatment for any kinds of infection)and laboratory findings(blood?cerebrospinal fluid?mechanical ventilation and central venous catheterization or removal of conventional catheter Results).The results of laboratory examination were determined by the Dalian children's Hospital.The data were processed by statistical software SPSS20.0.Data count was compared by chi square test and measurement data were used `X±S.Data count were analyzed by single factor analysis,then there was a significant difference in the single factor analysis and multivariate Logistic regression analysis to determine the correlation between dependent variables and the infection rate and the difference was statistically significant(P <0.05).Results:1.A total of 3600 patients,55 cases of nosocomial infection,the incidence of nosocomial infection is 1.53%.The average body weight(2034.09 ± 127)g in the infected group was lower than that in the non-infected group(3200.66 ± 226)g,the difference was statistically significant(P <0.05);The average gestational age(158.96 ±32.6)days in the infected group was lower than that in the non-infected group(259.96± 79.5)days,the difference was statistically significant(P<0.05);the average hospitalization time(32.18 + 2.39)days in the infected group was more than the average hospitalization time of non-infected group(6.69 + 1.39)days,the difference was statistically significant(P < 0.05).2.Of 55 cases of neonatal nosocomial infection,there were 57 kinds of diseases for nosocomial infection,sepsis(54.40%),thrush(22.81%),pneumonia(8.77%),upper respiratory tract infection(5.26%);54 patients cured,1 improved,the cure rate was98.2%.38 cases of lumbar puncture,cerebrospinal fluid abnormal in 18 cases;26 cases of blood culture examination,blood culture positive in 7 cases,blood culture results of gram-negative bacilli in 5 cases,Gram-positive 2 cases.3.Of 55 cases of neonatal nosocomial infection :low birth weight infants(70.91%)?extremely low birth weight infants(40%)?normal birth weight infants(29.09%)? very low birth weight infants(3.64%);the incidence of nosocomial infection rate in gestational age < 33 weeks was 58.18%.The incidence of neonatal infection in 37 weeks of gestational age was about 29.09%.Drug selection after infection in hospital:first cell risperidone sulbactam(45.45%)and nystatin(23.64%)and meropenem(20.20%),ceftriaxone(16.36%),mezlocillin sodium(10.91%).4.Univariate analysis showed that the infected group and non infected group of newborns in the rescue had significant difference in the number of treatment after birth history? mode of delivery and pregnancy,maternal abnormality ?the use antibiotics before infection ? central venous catheterization ? parenteral nutrition ? ventilator use.Logistic regression analysis showed that the use of antibiotics before infection?the history of rescue after birth and the mode of delivery were independent risk factors for nosocomial infection.Conclusions:1.The incidence of infection is low in domestics compared to foreign research results;the main infection is sepsis followed by thrush.2.Low birth weight infants and premature infants are prone to nosocomial infection.With the increase of body weight and gestational age,the incidence of nosocomial infection is reduced,The main pathogentic bacteria is gram-negative bacteria and fungi.3.The use of antibiotics before infection?the history of rescue after birth and the mode of delivery were independent risk factors for nosocomial infection.