某儿童医院住院患者医院感染现患率调查与分析
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摘要
目的了解儿童医院住院患者医院感染现患率及危险因素,为预防医院感染提供科学依据。方法采用横断面调查方法,连续5年对某儿童医院住院患者医院感染现患率进行调查与分析。结果该儿童医院2013-2017年住院患者医院感染现患率分别为4. 19%、4. 83%、4. 66%、2. 30%和3. 43%;感染患者居前3位科室依次是五官科、小儿内科和小儿外科,感染部位呼吸道和手术部位居多。2015-2017年连续3年医院感染患者病原学标本检出阳性率依次为32. 50%、56. 52%和66. 67%。Logistic回归分析显示,医院感染独立危险因素主要是年龄、动静脉插管及其他侵入性操作。结论连续5年医院感染现患率较低,多重耐药菌分离率较高,侵袭性操作感染发生风险较大。
Objective To explore the prevalence rate and risk factors of hospital acquired infection at a children’s hospital,to provide evidence to prevent hospital acquired infection. Methods The prevalence rate of hospital acquired infection was investigated and analyzed by cross-sectional survey for 5 years at a children’s hospital. Results The results demonstrated that the prevalence rate of hospital acquired infection of inpatients were 4. 19%,4. 83%,4. 66%,2. 30% and 3. 43% from2013 to 2017,respectively. The first three departments were ophthalmology and otorhinolaryngology,pediatric internal medicine and pediatric surgery with patients of hospital acquired infection,and the highest rate of hospital acquired infection were respiratory tract and surgical site. The infection rate of the pathogen test of hospital acquired infection were 32. 50%,56. 52% and 66. 67% from 2015 to 2017,respectively. The Logistic regression analysis showed that age more than one year old,arteriovenous catheterization and invasive medical operation were independent risk factors for hospital acquired infection. Conclusions There was a lower prevalence rate of hospital acquired infection,the isolation rate of multiple resistance was high,and there was a greater risk with invasive medical operation of hospital acquired infection in the hospital.
Objective To explore the prevalence rate and risk factors of hospital acquired infection at a children’s hospital,to provide evidence to prevent hospital acquired infection. Methods The prevalence rate of hospital acquired infection was investigated and analyzed by cross-sectional survey for 5 years at a children’s hospital. Results The results demonstrated that the prevalence rate of hospital acquired infection of inpatients were 4. 19%,4. 83%,4. 66%,2. 30% and 3. 43% from2013 to 2017,respectively. The first three departments were ophthalmology and otorhinolaryngology,pediatric internal medicine and pediatric surgery with patients of hospital acquired infection,and the highest rate of hospital acquired infection were respiratory tract and surgical site. The infection rate of the pathogen test of hospital acquired infection were 32. 50%,56. 52% and 66. 67% from 2015 to 2017,respectively. The Logistic regression analysis showed that age more than one year old,arteriovenous catheterization and invasive medical operation were independent risk factors for hospital acquired infection. Conclusions There was a lower prevalence rate of hospital acquired infection,the isolation rate of multiple resistance was high,and there was a greater risk with invasive medical operation of hospital acquired infection in the hospital.
引文
[1]刘桂芝,孙迎娟,陈庆增,等.医院感染现患率调查与分析[J].中华医院感染学杂志,2011,21(1):43-45.
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[11]Sun Z,Zhu Y,Xu G,et al.Regression analysis of the risk factors for postoperative nosocomial infection in patients with abdominal tumors:experience from a large cancer centre in China[J].Drug Discov Ther,2015,9(6):411-416.
[12]Maziere S,Couturier P,Gavazzi G.Impact of functional status on the onset of nosocomial infections in an acute care for elders unit[J].J Nutr Health Aging,2013,17(10):903-907.
[13]Alp E,Coruh A,Gunay GK,et al.Risk factors for nosocomial infection and mortality in burn patients:10 years of experience at a university hospital[J].J Burn Care Res,2012,33(3):379-385.
[14]荣红辉,刘运喜,曹圣山,等.神经外科颅脑手术患者医院感染危险因素分析[J].中国感染控制杂志,2014,13(8):463-466.
[15]靳桂明,董玉梅,张瞿璐,等.开颅手术后颅内感染相关危险因素的Logistic回归分析[J].中国临床神经外科杂志,2008,13(3):149-151.
[2]Smyth ET,Mc Ilvenny G,Enstone JE,et al.Four country healthcare associated infection prevalence survey 2006:overview of the results[J].J Hosp Infect,2008,69(3):230-248.
[3]中华人民共和国卫生部.医院感染诊断标准(试行)[S].2001.
[4]任南,文细毛,吴安华.2014年全国医院感染横断面调查报告[J].中国感染控制杂志,2016,15(2):83-87.
[5]Zarb P,Coignard B,Griskeviciene J,et al.The European Centre for Disease Prevention and Control(ECDC)pilot point prevalence survey of healthcare-associated infections and antimicrobial use[J].Euro Surveillance,2012,17(46):4-19.
[6]格日乐,李成,原源.2014年医院感染横断面调查结果分析[J].中国卫生检验杂志,2015,25(9):1442-1448.
[7]Shlaes DM,Gerding DN,John JF,et al.Society for Healthcare Epidemiology of America and Infectious Diseases Society of America Joint Committee onthe Prevention of Antimicrobial Resistance:guidelines for the prevention of antimicrobial resistance in hospitals[J].Infect Control Hosp Epidemiol,1997,18(4):275-291.
[8]Denise C,Teresa H,Mary A,et al.National Nosocomial Infections Surveillance System,National Nosocomial Infections Surveillance(NNIS)System Report,data summary from January 1992 through June 2004,issued October 2004[J].Am J Infect Control,2004,32(8):470-485.
[9]Kollef MH,Golan Y,Micek ST,et al.Appraising contemporary strategies to combat multidrugresistant gram-negative bacterial infections-proceedings and data from the Gram-Negative Resistance Summit[J].Clin Infect Dis,2011,53(Suppl 2):S33-S55.
[10]Popoola VO,Tamma P,Reich NG,et al.Risk factors for persistent methicillin-resistant Staphylococcus aureus colonization in children with multiple intensive care unit admissions[J].Infect Control Hosp Epidemiol,2013,34(7):748-750.
[11]Sun Z,Zhu Y,Xu G,et al.Regression analysis of the risk factors for postoperative nosocomial infection in patients with abdominal tumors:experience from a large cancer centre in China[J].Drug Discov Ther,2015,9(6):411-416.
[12]Maziere S,Couturier P,Gavazzi G.Impact of functional status on the onset of nosocomial infections in an acute care for elders unit[J].J Nutr Health Aging,2013,17(10):903-907.
[13]Alp E,Coruh A,Gunay GK,et al.Risk factors for nosocomial infection and mortality in burn patients:10 years of experience at a university hospital[J].J Burn Care Res,2012,33(3):379-385.
[14]荣红辉,刘运喜,曹圣山,等.神经外科颅脑手术患者医院感染危险因素分析[J].中国感染控制杂志,2014,13(8):463-466.
[15]靳桂明,董玉梅,张瞿璐,等.开颅手术后颅内感染相关危险因素的Logistic回归分析[J].中国临床神经外科杂志,2008,13(3):149-151.