省级儿童医院连续七年医院感染现患率趋势分析
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摘要
目的了解儿童专科医院医院感染现患率连续变化趋势。方法 2012年7月—2018年11月期间,采用横断面调查方法,应用查阅病历和床旁调查相结合方式,连续7年对全院住院患儿进行医院感染现患率调查。结果 7年共调查住院患儿10 310例,2012年—2018年各年医院感染例次率分别为2.08%、4.84%、1.59%、3.76%、1.63%、1.74%、2.08%,总体呈下降趋势(LLA=7.631,P=0.006)。医院感染发生科室类别构成比从高到低依次为儿外科(50.0%)、儿内科(44.8%)、新生儿内科(2.8%)和重症监护病房(2.4%)。医院感染病原体以病毒(38.8%)最为常见,其次为革兰阴性菌(34.3%)。结论儿童专科医院感染现患率总体呈现下降趋势,医院感染发生科室以儿外科最常见,病原体以病毒最常见。该结论可为儿童医院感染防控提供参考。
Objective To explore the continuous changing trend of healthcare-associated infection prevalence rate in a children's hospital. Methods From July 2012 to November 2018, a cross-sectional survey was conducted to investigate the prevalence of healthcare-associated infections in hospitalized children for seven consecutive years by combining case-checking and bedside survey. Results A total of 10 310 hospitalized children were investigated in the past seven years. The incidence of healthcare-associated infections from 2012 to 2018 was 2.08%, 4.84%, 1.59%, 3.76%,1.63%, 1.74%, and 2.08%, respectively, showing a statistically significant downward trend(LLA=7.631, P=0.006). The departments with higher proportion of healthcare-associated infections were pediatric surgery(50.0%), pediatric medicine(44.8%), neonatal medicine(2.8%), and intensive care units(2.4%). Viruses(38.8%) were the most common pathogens of healthcare-associated infections, followed by Gram-negative bacteria(34.3%). Conclusions The prevalence of healthcare-associated infections in the children's hospital showed a downward trend year by year. Pediatric surgery is the most common occurrence department, and viruses are the most common pathogens. It can provide evidence for prevention and control of healthcare-associated infection in children's hospitals.
Objective To explore the continuous changing trend of healthcare-associated infection prevalence rate in a children's hospital. Methods From July 2012 to November 2018, a cross-sectional survey was conducted to investigate the prevalence of healthcare-associated infections in hospitalized children for seven consecutive years by combining case-checking and bedside survey. Results A total of 10 310 hospitalized children were investigated in the past seven years. The incidence of healthcare-associated infections from 2012 to 2018 was 2.08%, 4.84%, 1.59%, 3.76%,1.63%, 1.74%, and 2.08%, respectively, showing a statistically significant downward trend(LLA=7.631, P=0.006). The departments with higher proportion of healthcare-associated infections were pediatric surgery(50.0%), pediatric medicine(44.8%), neonatal medicine(2.8%), and intensive care units(2.4%). Viruses(38.8%) were the most common pathogens of healthcare-associated infections, followed by Gram-negative bacteria(34.3%). Conclusions The prevalence of healthcare-associated infections in the children's hospital showed a downward trend year by year. Pediatric surgery is the most common occurrence department, and viruses are the most common pathogens. It can provide evidence for prevention and control of healthcare-associated infection in children's hospitals.
引文
1吴安华,任南,文细毛,等.全国医院感染监控网1998~1999年监测资料分析.中华医院感染学杂志,2000,10(6):401-403.
2中华人民共和国卫生部.医院感染诊断标准(试行).中华医学杂志,2001,81(5):314-320.
3中华人民共和国卫生部.卫生部办公厅关于印发《外科手术部位感染预防与控制技术指南(试行)》等三个技术文件的通知.(2010-11-29)[2019-01-01].http://www.nhfpc.gov.cn/mohyzs/s3594/201012/50039.shtml.
4钟佩佩,张津,狄军波,等.温州某医院2010-2016年儿童感染病门诊疾病谱.国际流行病学传染病学杂志,2018,45(3):187-191.
5张冀炜,马惠珍.儿科门诊疾病种类及分布特点分析.宁夏医学院学报,2006,28(4):349-350.
6匡寒琴.28096例儿童住院疾病谱及费用分析.中国病案,2016,17(1):53-55.
7任南,文细毛,吴安华.全国医院感染横断面调查结果的变化趋势研究.中国感染控制杂志,2007,6(1):16-18.
8任南,细毛,吴安华.2014年全国医院感染横断面调查报告.中国感染控制杂志,2016,15(2):83-87.
9Dudeck MA,Weiner LM,Allen-Bridson K,et al.National healthcare safety network(NHSN)report,data summary for 2012,device-associated module.Am J Infect Control,2013,41(12):1148-1166.
10余淑霞,许婷,马鸿云.2013-2017年医院感染现患率调查分析.中华医院感染学杂志,2018,28(8):1175-1178.
11程兴东,陈雪梅,李同欢,等.住院患儿医院感染现患率与相关因素分析.中华医院感染学杂志,2018,28(12):1888-1891.
12许姜姜,高洁,郭骏华,等.2012至2017年某儿童专科医院住院患儿医院感染的部位及病原体分布.中国循证儿科杂志,2018,13(4):264-268.
13程莉莉,张秀月,齐月,等.某三级甲等医院2011-2016年医院感染现患率调查分析.中国消毒学杂志,2018,35(11):868-870.
14李碧兰,蒋禹.心脏瓣膜置换术后下呼吸道感染的相关因素分析.华西医学,2015,30(10):1924-1926.
15Riera M,Ibá?ez J,Herrero J,et al.Respiratory tract infections after cardiac surgery:impact on hospital morbidity and mortality.J Cardiovasc Surg(Torino),2010,51(6):907-914.
16谭昆,魏诗晴,徐敏,等.心脏大血管术后患者医院感染特征及相关因素分析.中华医院感染学杂志,2018,28(8):1216-1219.
2中华人民共和国卫生部.医院感染诊断标准(试行).中华医学杂志,2001,81(5):314-320.
3中华人民共和国卫生部.卫生部办公厅关于印发《外科手术部位感染预防与控制技术指南(试行)》等三个技术文件的通知.(2010-11-29)[2019-01-01].http://www.nhfpc.gov.cn/mohyzs/s3594/201012/50039.shtml.
4钟佩佩,张津,狄军波,等.温州某医院2010-2016年儿童感染病门诊疾病谱.国际流行病学传染病学杂志,2018,45(3):187-191.
5张冀炜,马惠珍.儿科门诊疾病种类及分布特点分析.宁夏医学院学报,2006,28(4):349-350.
6匡寒琴.28096例儿童住院疾病谱及费用分析.中国病案,2016,17(1):53-55.
7任南,文细毛,吴安华.全国医院感染横断面调查结果的变化趋势研究.中国感染控制杂志,2007,6(1):16-18.
8任南,细毛,吴安华.2014年全国医院感染横断面调查报告.中国感染控制杂志,2016,15(2):83-87.
9Dudeck MA,Weiner LM,Allen-Bridson K,et al.National healthcare safety network(NHSN)report,data summary for 2012,device-associated module.Am J Infect Control,2013,41(12):1148-1166.
10余淑霞,许婷,马鸿云.2013-2017年医院感染现患率调查分析.中华医院感染学杂志,2018,28(8):1175-1178.
11程兴东,陈雪梅,李同欢,等.住院患儿医院感染现患率与相关因素分析.中华医院感染学杂志,2018,28(12):1888-1891.
12许姜姜,高洁,郭骏华,等.2012至2017年某儿童专科医院住院患儿医院感染的部位及病原体分布.中国循证儿科杂志,2018,13(4):264-268.
13程莉莉,张秀月,齐月,等.某三级甲等医院2011-2016年医院感染现患率调查分析.中国消毒学杂志,2018,35(11):868-870.
14李碧兰,蒋禹.心脏瓣膜置换术后下呼吸道感染的相关因素分析.华西医学,2015,30(10):1924-1926.
15Riera M,Ibá?ez J,Herrero J,et al.Respiratory tract infections after cardiac surgery:impact on hospital morbidity and mortality.J Cardiovasc Surg(Torino),2010,51(6):907-914.
16谭昆,魏诗晴,徐敏,等.心脏大血管术后患者医院感染特征及相关因素分析.中华医院感染学杂志,2018,28(8):1216-1219.