新生儿重症监护室的新生儿重症监护室的新生儿重症监护室的新生儿重症监护室的新生儿重症监护室
Erica C Prochaska1,2, Shaoming Xiao1, Elizabeth Colantuoni3
1Division of Pediatric Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
JAMA pediatrics
|June 24, 2024
概括
新生儿重症监护室 (NICU) 的医院发病细菌病 (HOB) 与较高的婴儿死亡率有关. 出生体重影响HOB风险,早产婴儿的发病率随着时间的推移而下降,较大的新生儿的发病率随着时间的推移而增加.
科学领域:
- 新生儿医学 新生儿医学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 疾病控制和预防中心将实施医院发病的细菌病 (HOB) 作为与医疗保健相关的感染指标.
- 新生儿重症监护室 (NICU) 婴儿中HOB的流行病学和临床特征仍然在很大程度上是未知的.
研究的目的:
- 为了确定新生儿重症监护室的婴儿中HOB的发病率.
- 评估HOB风险与出生体重和产后年龄之间的关联.
- 为了量化HOB可归因的死亡率.
主要方法:
- 一项回顾性,多中心队列研究和模拟试验,涉及2016年至2021年美国322个NICU.
- 包括接受参与NICU至少4天的婴儿.
- 主要暴露包括出生体重和产后年龄;结果是HOB和HOB归因的死亡率.
主要成果:
- 在451,443名婴儿中,2% (8,356) 患有9,015个HOB事件. 未调整的发病率为每1000个患者日1.1个.
- 根据出生体重,HOB的发病率差异很大,婴儿<=750g (14.2/1000患者日) 的发病率最高,婴儿>2500g (0.4/1000患者日) 的发病率最低.
- 可归因于HOB的死亡率为5.5%. 在低出生体重的婴儿中,相对HOB风险随着产后年龄的增加而降低,但在高出生体重的婴儿中增加.
结论:
- 在NICU的HOB事件与增加的死亡率有关.
- 出生体重是HOB的关键风险因素,在出生后的年龄中存在明显的风险模式.
- 迫切需要制定HOB预防策略和降低风险的计划,以减少婴儿死亡率.
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