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目的:描述医院儿科住院患者院内感染的流行特征,探索医院儿科住院患者院内感染的危险因素,为临床预防措施的制定提供参考。方法:采用回顾性分析的方法对2012年1月～10月该院儿科住院的2 710例患儿的院内感染情况进行感染描述性研究以及危险因素的病例对照研究。结果:2 710例患儿中,发生院内感染224例,感染率8.26%。其中呼吸系统、消化系统、皮肤位居医院感染易发的前3位,感染患儿例数分别为64(28.57%)、41(18.30%)、32(14.28%)。医院感染的224例患儿中共有96份标本进行病原学检查,检出51株病原,病毒、细菌、真菌的株数分别为9(17.65%)、28(54.90%)、14(27.45%)。导致患儿发生院内感染的单因素为:并发症和主要诊断、抗生素使用不当、重症监护、营养情况、治疗操作不当。新生儿发生院内感染的单因素为:体重、胎龄、原发性疾病、Apgar评分高低。在患儿院内感染多因素分析结果为:住院时间、并发症和主要诊断、抗生素使用类别。结论:儿科患者住院期间发生感染的情况比较普遍,主要危险因素为:住院时间、并发症和主要诊断、抗生素使用类别。以上因素之外还要根据住院患儿的特殊因素进行全面的分析。
Objective: To describe the epidemiological characteristics of nosocomial infections in hospital pediatric inpatients and to explore the risk factors of nosocomial infections in hospital pediatric inpatients, so as to provide reference for the development of clinical preventive measures. Methods: A retrospective analysis was conducted to describe the nosocomial infections in 2 710 hospitalized pediatric patients in January-October 2012 in a descriptive and infectious case-control study of risk factors. Results: Among 2 710 children, 224 cases of nosocomial infection occurred and the infection rate was 8.26%. Among them, respiratory system, digestive system and skin were among the top three most common nosocomial infections. The number of infected children were 64 (28.57%), 41 (18.30%) and 32 (14.28%) respectively. A total of 96 samples from 224 hospitalized children were etiologically examined. The number of pathogens, viruses, bacteria and fungi in 51 isolates were 9 (17.65%), 28 (54.90%) and 14 (27.45%), respectively. The single factors that led to nosocomial infections in children were: complications and major diagnoses, improper use of antibiotics, intensive care, nutritional status, and improper treatment. Neonatal nosocomial infections in the single factor: weight, gestational age, primary disease, Apgar score level. The results of multivariate analysis of nosocomial infections in infants were: length of hospital stay, complications and major diagnoses, antibiotic use categories. CONCLUSIONS: Inpatients with pediatric infections are more common during hospitalization. The main risk factors are length of stay, complications and major diagnoses, and types of antibiotics used. In addition to the above factors but also based on the special factors of hospitalized children for a comprehensive analysis.