|
|
|
| Retrospective Analysis of Factors Influencing PICC-Related Bloodstream Infections in NICU Low Birth Weight Infant |
| WU Xianlin, YIN Zhuan, FANG Yuqi, XIANG Qiuhong, YANG Xiaoqin, XIONG Lijuan |
| Changsha Hospital for Maternal & Child Health care Affiliated to Hunan Normal University, Changsha 410007, China |
|
|
|
|
Abstract Objective To explore the influencing factors of peripherally inserted central catheter (PICC) -related infections in low birth weight infants in the Neonatal Intensive Care Unit (NICU) and provide a basis for PICC placement in NICUs. Methods We included low birth weight infants who were hospitalized in a tertiary hospital in Changsha City from January 2021 to June 2022 and underwent PICC placement. We retrospectively analyzed their clinical data, used a case-control method, with those who experienced catheter-related infections as the case group and those who did not as the control group. We conducted univariate and multivariate logistic regression analyses to investigate the risk factors for catheter-related bloodstream infections. Results A total of 19 low birth weight infants developed catheter-related bloodstream infections during a total catheterization duration of 3,466 days, with an infection rate of 0.5% per catheter day. The results of logistic regression analysis showed that birth weight<1 000 g (OR=0.266, 95% CI 0.084-0.842) and catheterization age≤7 days (OR=0.193, 95% CI 0.057-0.653) were risk factors. Birth weight and the age at catheter placement, when combined, have a maximum area under the curve of 0.741 and an approximate odds ratio of 0.369. This combination is more effective in predicting Catheter-related bloodstream infection in low birth weight infants compared to individual factors alone. Conclusion For low birth weight infants, especially those with a birth weight of less than 1 000 g and premature infants with catheter placement at ≤7 days of age, increased vigilance and preventive measures should be taken to reduce the occurrence of Catheter-related bloodstream infection.
|
|
Received: 13 September 2023
|
|
|
|
|
|
[1] 刘晓娟, 黄丽. 经胸壁B超定位法在早产儿PICC置管中的应用效果观察[J]. 航空航天医学杂志, 2022, 33(11): 1393-1396.
[2] 刘阁, 封洁. PICC置管新生儿发生导管相关性感染的影响因素[J]. 中国民康医学, 2022, 34(22): 17-19.
[3] 李兰, 温贤秀. 早产儿PICC置管研究进展[J]. 护理学杂志, 2021, 36(21): 110-113.
[4] 余卓文, 顾莺, 张玉侠, 等. 经外周穿刺中心静脉导管在普通儿科病房中长期输液患儿应用的可行性研究[J]. 中国循证儿科杂志, 2017, 12(02): 100-105.
[5] OZKIRAZ S, GOKMEN Z FAU - ANUK INCE D, ANUK INCE D FAU - AKCAN A B, et al. Peripherally inserted central venous catheters in critically ill premature neonates[J]. J Vasc Access, 2013, 14(4): 320-324.
[6] 张晓琴, 何淑贞. 早产儿PICC导管相关血流感染的卫生经济学分析[J]. 护理研究, 2020, 34(14): 2593-2596.
[7] 李蕊, 王晶, 王佳琦, 等. 极/超低出生体质量儿经外周静脉置入中心静脉导管相关并发症及影响因素分析[J]. 解放军护理杂志, 2020, 37(04): 51-54.
[8] 中华人民共和国卫生部. 医院感染诊断标准 (试行)[J]. 中华医学杂志, 2001, 81(05): 314-320.
[9] 谢建宁, 高平明, 黄朝梅, 等. 新生儿导管相关血流感染危险因素分析[J]. 实用医学杂志, 2018, 34(04): 618-620.
[10] 朱秀丽, 徐帅, 张艳梅. 新生儿PICC导管相关性感染的影响因素分析[J]. 航空航天医学杂志, 2023, 34(08): 913-915.
[11] DUDECK MA, EDWARDS JR, ALLEN-BRIDSON K, et al.National Healthcare Safety Network report, data summary for 2013, Device-associated Module[J]. Am J Infect Control, 2015, 43(3): 206-221.
[12] 贺尹俊. 导致接受PICC置管的新生儿发生导管相关性感染的危险因素分析[J]. 当代医药论丛, 2020, 18(04): 94-95.
[13] PERLMAN S E, SAIMAN L, LARSON E L, et al.Risk factors for late-onset health care-associated bloodstream infections in patients in neonatal intensive care units[J]. Am J Infect Control, 2007, 35(3): 177-182.
[14] 赵小朋, 周伟, 李旭芳, 等. 极低/超低出生体重儿迟发型败血症发生情况及其危险因素分析[J]. 中国当代儿科杂志, 2017, 19(11): 1129-1133.
[15] 宋华芳, 陈晓君, 吴芳芳. 新生儿经外周静脉穿刺中心静脉置管相关性感染干预的效果分析[J]. 中国基层医药, 2022, 29(07): 1071-1074.
[16] 华敏敏, 夏磊, 肖晴, 等. 极低出生体质量儿PICC相关血流感染的危险因素[J]. 中国感染控制杂志, 2022, 21(04): 384-388.
[17] 秦承霞. 低出生体重儿发生新生儿肺炎相关影响因素分析[D]. 呼和浩特: 内蒙古医科大学, 2023.
[18] SHANE AL, SÁNCHEZ PJ, STOLL BJ. Neonatal sepsis[J]. Lancet, 2017, 390(10104): 1770-1780. |
|
|
|
2024, Vol. 21 
