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目的:分析毛细支气管炎患儿院内感染危险因素分析及干预措施。方法:选择2008年1月~2013年12月该院收治的毛细支气管炎患儿4 352例,其中医院内感染患儿共358例。对院内感染患儿进行血清病检测及免疫荧光法检测,且将患儿所取的痰液标本制成悬液标本,取菌液接种于哥伦比亚选择性培养液,置CO2培养箱培养。结果:358例患儿中,病毒感染者所占比例明显高于其他类型的病原菌,占77.09%(P>0.05)。患儿由呼吸道合胞病毒感染的居多,有115例,其次为副流感病毒25例和人类偏肺病毒23例,真菌感染的相对较少。年龄分布相对均匀,呼吸道合胞病毒及细菌者总体小于平均中位年龄,其他病毒及真菌、支原体、衣原体大于平均中位年龄。呼吸道合胞病毒冬季的感染率较高,病毒的感染整体上春秋的发病率略高于其他季节,细菌、真菌和其他微生物感染,随季节的变化,差异不明显,整体发病情况,冬季略高于其他季节。季节因素、病情因素、遗传因素、自身因素是患儿患毛细支气管炎的主要危险因素。结论:毛细支气管炎患儿院内感染要特别注意患儿在院的卫生,包括奶甁、衣物的清洗,尽量少接触高传染源。对于病毒的季节和患儿的年龄也要特别留意。
Objective: To analyze the risk factors of nosocomial infection in children with bronchiolitis and the intervention measures. Methods: A total of 4 352 bronchiolitis patients admitted to our hospital from January 2008 to December 2013 were selected, of which 358 were hospital-acquired infections. Serum tests and immunofluorescence test were performed on children with nosocomial infection, and the sputum specimens taken from the children were made into suspension samples. The bacterial cultures were inoculated into selective culture medium in Colombia and cultured in CO2 incubator. Results: Among 358 children, the proportion of virus-infected persons was significantly higher than that of other types of pathogens, accounting for 77.09% (P> 0.05). The majority of children with respiratory syncytial virus infection, 115 cases, followed by 25 cases of parainfluenza virus and 23 cases of human metapneumovirus, fungal infection is relatively small. Age distribution is relatively uniform, respiratory syncytial virus and bacteria were less than the average median age, other viruses and fungi, mycoplasma, chlamydia than the median age. The infection rate of respiratory syncytial virus was higher in winter, and the incidence of virus infection was slightly higher in spring and autumn than in other seasons. The infection rate of bacteria, fungi and other microorganisms was not significantly different with the seasons, but the overall incidence was slightly higher in winter In other seasons. Seasonal factors, disease factors, genetic factors, their own factors in children with bronchiolitis is the main risk factor. CONCLUSIONS: Infection of patients with bronchiolitis should pay special attention to nosocomial infection in children, including cleaning of milk and clothes, and minimizing exposure to high levels of infection. Pay special attention to the season of the virus and the age of the child.