小儿ICU医院感染目标性监测分析

Study on targeted surveillance of nosocomial infection in ICU of pediatrics

目的了解小儿ICU医院感染发病特点及规律。方法采用目标性监测的方法,前瞻性地研究2009年4月-2010年3月ICU患儿医院感染发病情况,用患者平均病情严重程度(ASIS)调整医院感染发生率,并对侵入性操作相关感染进行分析。结果 883例住院患儿中,发生医院感染103例次,例次感染率为11.66%,患者日例次感染率为15.30‰,经ASIS调整后患者日医院感染率为4.15‰;3种侵入性操作相关性感染日感染率分别为:呼吸机相关性肺炎49.44‰、留置导尿管相关性泌尿道感染2.41‰、动静脉插管相关性血液感染0.99‰。结论小儿ICU医院感染发生率较高,与应用各种导管相关,以呼吸机相关性肺炎为主;应重视目标性监测,加强对侵入性操作的管理与干预。

OBJECTIVE To study the characteristics of nosocomial infection in pediatrics in ICU.METHODS The nosocomial infection in pediatrics in ICU from Apr.2009 to Mar.2010 were prospectively studied by using the method of objective surveillance,the nosocomial infection rate was regulated by the method of ASIS,the invasive procedure and the associated infection rate were analyzed.RESULTS Among 883 cases of inpatients in pediatrics in ICU,103 case-times suffered from nosocomial infection with the case-time rate of 11.66%,the day nosocomial infection rate was 15.30‰,the day nosocomial infection rate was 4.15‰ after the regulation by the method of ASIS.The nosocomial infection rates associated with 3 invasive procedure were ventilator associated pneumonia（VAP） 49.44‰,indwelling catheter associated urinary infection 2.41‰,vascular catheter associated blood infection 0.99‰.CONCLUSION Nosocomial infection rate in pediatrics in ICU is higher.which is related to varieties of catheters and the first is ventilator associated pneumonia.We should pay attention to the targeted surveillance and strengthen the management and intervention of the invasive operation.