ObjectiveTo assess the factors inlfuencing the therapeutic effects of INSURE technology in premature in-fants with respiratory distress syndrome (NRDS).MethodsThe clinical data from 309 infants with NRDS treated by INSURE technology were retrospectively analyzed from Jan. 2000 to Dec. 2012.ResultsIn 309 infants with NRDS, 302 infants were cured and the cure rate was 97.7%. Twenty-one infants (6.8%) needed the reintubation for mechanical ventilation within 72 h. The difference in reintubation rate was statistically signiifcant among infants with different gestational age (P<0.01). The infants with the gestation age≤28 weeks had a signiifcantly higher reintubation rate. According to whether the reintubation was performed, the infants were divided into success group and failure group. Compared to the success group, there were higher percentage of infants who had gestation age≤28 weeks, birth weight <1000 g and severe NRDS, needed high dose and repeated use of pulmo-nary surfactant and oxygen therapy, and had higher mortality in the failure group had (allP<0.05).ConclusionsThe INSURE technology can be effective in treatment of NRDS. Small gestational age, low birth weight, and severe NRDS are the risk factors for the failure of the INSURE technology.

Objectives To discuss the clinical characteristic, cause and measures to prevention and control of nosocomial infection in a neonatal intensive care unit (NICU). Methods Retrospectively analyzed an nosocomial infection outbreak of Klebsiella pneumoniae in NICU. Results From Sept. 3, 2010 to Oct. 3, 2010, there were 7 cases of hospital infection in 12 cases of sputum cultured Klebsiella Pneumoniae. The gestational age (GA) of 7 hospital infection cases was 28.5±2.6 week. The birth weight of infection cases was 941.4±309.8 g. The onset of infection was at 31.7±12.8 d of hospitalization. The nosocomial incidence was 2.41%in the hospital, which was 5.79%in preterm infants, 50.00%in GA<28w infants, and 42.86%in extremely low birth weight infant (ELBW). All sputum culture results were displayed as multi-drug resistant of Klebsiella pneumoniae, penicillin and third-generation cephalosporin antibiotic resistance rate of 75%to 100%. The resistance rates to penicillin and cephem antibiotics were 75% -100%, carbapenems was 58.3%, piperacillin/tazobactam was 25.0%. All nosocomial patients were cured. Conclusions GA<28w and ELBW infants are at increased risk of nosocomial infection in NICU. The emergence of carbapenems resistant Klebsiella Pneumoniae has been increasing with the widespread use of carbapenems. Hospital infection can be controlled by standardized medical behavior, which can decline the nosocomial infection incidence and mortality of preterm infants in NICU.