Clinical analysis of nosocomial infection and risk factors of extremely premature infants.

Na Jiang; Ying Wang; Qi Wang; Haijing LI; Jingyun Mai; Zhenlang Lin

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Clinical analysis of nosocomial infection and risk factors of extremely premature infants.

Author: Na JIANG ¹ ; Ying WANG ¹ ; Qi WANG ¹ ; Haijing LI ¹ ; Jingyun MAI ¹ ; Zhenlang LIN ²
Author Information

1. Department of Neonatology, Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China.
2. Department of Neonatology, Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China. Email: linzhenlang@hotmail.com.
Publication Type:Journal Article
MeSH: Birth Weight; Catheterization, Central Venous; adverse effects; Cross Infection; epidemiology; microbiology; Female; Gram-Negative Bacteria; isolation & purification; Gram-Positive Bacteria; isolation & purification; Humans; Incidence; Infant, Extremely Premature; Infant, Newborn; Infant, Premature, Diseases; epidemiology; microbiology; Intensive Care Units, Neonatal; Logistic Models; Male; Pneumonia, Ventilator-Associated; epidemiology; microbiology; Respiration, Artificial; adverse effects; Retrospective Studies; Risk Factors; Sepsis; epidemiology; microbiology
From: Chinese Journal of Pediatrics 2014;52(2):137-141
CountryChina
Language:Chinese
Abstract:
OBJECTIVETo investigate the incidence of nosocomial infections of extremely premature infants and to explore the risk factors and strategies for infection control.
METHODThere were 118 extremely premature infants who were confirmed to have nosocomial infection in neonatal intensive care unit of the authors' hospital from January 2008 to December 2012. Their data of the infection rate, risk factors and clinical characteristics were retrospectively analyzed.
RESULTDuring the study, nosocomial infection occurred in 78 extremely premature infants 129 times. The nosocomial infection rate was 66.10%. The rate of ventilator-associated pneumonia (VAP) was 1.43% (35/2 452). The catheter related blood stream infection (CRBSI) rate was 0.35% (16/4 613). There were 74 (57.36%) cases of pneumonia, which was the most common nosocomial infection of extremely premature infants. There were 35 cases of VAP, which accounted for 47.30% of pneumonia. The next was sepsis, 48 cases. Seventy-four (74/90, 82.22%) strains of isolates were Gram-negative bacteria, which accounted for the highest proportion, followed by Gram-positive (12 strains), fungus (4 strains); Klebsiella pneumonia is the most common pathogens of nosocomial infection in extremely premature infants. The isolation rates of Klebsiella pneumonia with positive extended-spectrum beta-lactamases (ESBL) were 90.91% (20/22) , universally resistant to cephalosporins. Single-factor analysis showed that the body weight, mechanical ventilation, umbilical vein catheterization, central venous catheter, parenteral nutrition and hospitalization time were risk factors for nosocomial infections in extremely preterm infants. Logistic regression analysis showed that length of hospitalization (OR = 1.024, P = 0.043) and central venous catheterization (OR = 6.170, P = 0.041) were independent risk factors of nosocomial infection.
CONCLUSIONExtremely preterm infants were at higher risk of nosocomial infection. It is important to identify the high risk factors for nosocomial infections in extremely premature infants. To shorten time for mechanical ventilation, central venous catheterization and hospitalization days would be conducive to reducing the morbidity of nosocomial infection.