某醫學中心新生兒加護病房院內感染Enterobacter species菌血症流行病學調查

Epidemiology and Risk Factors for Nosocomial Enterobacter Bacteremia at Neonatal Intensive Care Unit in a Medical Center

孫淑美(Sun-Mei Shu) ； 陳瑛瑛(Yin-Yin Chen) ； 王復德(Fu-Der Wang)

《感染控制雜誌》 19卷2期 (2009/04) Pp. 81-89

https://doi.org/10.6526/ICJ.200904_19(2).0002

摘要

Nosocomial infections and outbreaks caused by Enterobacter have been reported elsewhere at hospitals, including neonatal intensive care units (NICUs). However, risk factors of acquisition of Enterobacter bacteremia in NICU had less been investigated. To understand the epidemiology and risk factors of nosocomial bacteremia caused by Enterobacter species at NICU, we performed a case-control study in a medical center from 2001 to 2007. Totally forty-nine patients had Enterobacter bacteremia, accounted for 37% of a11 bacteremia at NICU during the study period. The most common isolated specie was Enterobacter cloacae. The prevalence of Enterobacter bacteremia had been increased from 26% in 2001 to 75% in 2007, with the infection density increased from 1.58 to 3.41 episodes per 1000 patient-days, respectively. By logistic regression, central venous catheterizations (odds ratio [OR], 3.15; 95% confidence interval [95% CI], 1.02-9.67) and use of parenteral nutrition (OR, 14.0; 95% CI, 3.07-63.75) were two independent factors associated with Enterobacter bacteremia. In conclusion, our results revealed that aseptic techniques before medical interventions, vigorous intravenous line nursing care and hand washing are important measures to prevent Enterobacter bacteremia at NICUs.

關鍵字

Enterobacter spp.菌血症 ； 新生兒加護病房 ； 院內感染

並列摘要

Nosocomial infections and outbreaks caused by Enterobacter have been reported elsewhere at hospitals, including neonatal intensive care units (NICUs). However, risk factors of acquisition of Enterobacter bacteremia in NICU had less been investigated. To understand the epidemiology and risk factors of nosocomial bacteremia caused by Enterobacter species at NICU, we performed a case-control study in a medical center from 2001 to 2007. Totally forty-nine patients had Enterobacter bacteremia, accounted for 37% of a11 bacteremia at NICU during the study period. The most common isolated specie was Enterobacter cloacae. The prevalence of Enterobacter bacteremia had been increased from 26% in 2001 to 75% in 2007, with the infection density increased from 1.58 to 3.41 episodes per 1000 patient-days, respectively. By logistic regression, central venous catheterizations (odds ratio [OR], 3.15; 95% confidence interval [95% CI], 1.02-9.67) and use of parenteral nutrition (OR, 14.0; 95% CI, 3.07-63.75) were two independent factors associated with Enterobacter bacteremia. In conclusion, our results revealed that aseptic techniques before medical interventions, vigorous intravenous line nursing care and hand washing are important measures to prevent Enterobacter bacteremia at NICUs.

並列關鍵字

Enterobacter bacteremia ； neonatal intensive care units NICUs ； nosocomial infection