712例不同出生体重新生儿感染流行病学特征分析

摘要

目的：调查新疆地区二级、三级医院不同出生体重新生儿患者感染发生及抗菌药物使用情况。方法采用床旁调查与病历调查相结合的方法，对2014年3月20日新疆二级及以上医院新生儿患者712例感染及抗菌药物使用信息进行横断面调查。结果调查712例新生儿患者多来自二级医院（80．76％），男性患儿居多（56．18％），民族构成中维吾尔族患者较多（54．49％），医院感染现患率为4．49％（例次现患率4．63％），社区感染现患率45．79％（例次现患率47．05％）。新生儿社区感染现患率病率明显高于医院感染现患率。不同出生体重组中极低出生体重组医院感染现患率最高，而正常出生体重组社区感染率最高（P ＜0．05）。呼吸道是医院感染及社区感染最常见部位。新生儿呼吸道医院感染发生率由高到低：极低出生体重组＞低出生体重组＞巨大儿组＞正常出生体重组。社区感染由高到低为：正常出生体重组＞巨大儿组＞低出生体重组＞极低出生体重组（χ2＝13．907，P＝0．003）。调查日新生儿抗菌药物使用率为58．43％，抗菌药物单用占主体（94．23％），治疗性用药较多（75．96％），巨大儿组抗菌药物使用率最高（67．74％），极低出生体重组二联用药构成比最高（28．57％）。结论应加强对低出生体重新生儿医院呼吸道感染的防控措施，并持续加强新生儿合理用药宣传指导及监测工作。%Objective To investigate the incidence of nosocomial infections in neonatal infections in Xinjiang Uygur Autonomous Region and to monitor the utilization of antibiotics.Methods Bedside investigation and medical record review were used for cross-sectional survey in 132 hospitals in March 20th of 2014.Re-sults Total of 712 newborn were investigated,coming from secondary hospitals (80.76%),mostly in the male (56.18%),Uighur patients (54.49%).The nosocomial infection rate was 4.49% (cases rate 4.63%), and community infection rate was 45.79% (cases rate 47.05%).Community infection rates were signifi-cantly higher than nosocomial infection rates in newborn.The very low birth weight group had the highest nosocomial infections rate,community infection rate were higher in normal birth weight group (P <0.05). The common infection sites were respiratory tract.Neonatal respiratory tract infection rate from high to low in different birth weight.nosocomial infection with very low birth weight groups>low birth weight group>Macrosomia group> normal birth weight group,and community infection just the reverse (chi-square=13.907,P =0.003).Antimicrobial usage rate was 58.43%,using of single drug (94.23%),thera-peutic usage of antibiotics made up 75.96%.Macrosomia group of antibacterial drug utilization rate was highest (67.74%), the highest was very low birth weight group in duplex medication (28.57%). Conclusion We need to pay more attention to the respiratory nosocomial infections of low birth weight newborn.To strengthen the prevention and control measures.Give more publicity and guidance to make more rational in drug use of the newborn,and monitoring constantly.