儿科血液病房医院感染的分析及预防

Analysis of nosocomial infections in blood ward pediatrics departments and the prevention measures

目的分析儿科血液病房医院感染发生情况,提出预防措施,为临床治疗提供参考。方法回顾性调查2010年1月-2012年1月血液病房2237份血液病患儿住院病历资料,分析医院感染发生情况。结果 2237例患儿发生医院感染218例,医院感染率9.75%,其中<1、1～3、3～7岁和>7岁患儿感染率分别为19.05%、8.89%、8.31%及8.60%,不同患儿医院感染发生率差异有统计学意义(P<0.05);感染部位前5位依次为上呼吸道、下呼吸道、肠道、血液及皮肤感染,分别占49.08%、15.60%、12.84%、7.80%和5.96%;细菌学共有54例阳性标本检出,其中血液标本数量居首位,感染病原体主要为细菌,占92.59%;前5位感染病原体为铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍氏不动杆菌、阴沟肠杆菌,分别占25.93%、16.67%、9.26%、9.26%和9.26%。结论儿科血液病房血液病患儿医院感染发生率较高,呼吸道感染居首位,感染病原体以革兰阴性菌为主,应制定针对性干预对策,预防控制血液病房医院感染的发生。

OBJECTIVE To explore the incidence of the nosocomial infections in the pediatric blood wards and put forward the prevention measures so as to guide the clinical treatment. METHODS The medical records of 2237 case-times of children who hospitalized the blood wards from Jan 2010 to Jan 2012 were retrospectively analyzed, and the incidence of the nosocomial infections was analyzed. RESULTS Of 2237 children investigated, the nosocomial infections occurred in 218 case-times of children with the incidence rate of 9. 75%, including the children aged less than 1 year old （19.05%）, the children age between 1 and 3 years （8.89%）, the children aged between 3 and 7 years （8. 31%） ,and the children aged more than 7 years （8.60%）, the difference in the infections rate between the various age groups was statistically significant （P〈0.05）; the incidence rates of the upper respiratory tract infections, lower respiratory tract infections, intestinal infections, blood infections, and skin infections were 49.08%, 15.60%, 12.84%, 7.80%, and 5.96%, respectively; there were totally 54 case-times of specimens tested positive, among which the blood specimens ranked the first place, and the isolated bacteria accounted for 92. 59 %;the Pseudomonas aeruginosa , Klebsiella pneumoniae , Escherichia coli , Acinetobacter baumannii, Enterobacter cloacae were the top 5 species of pathogens, accounting for 25.93 %, 16.67 %, 9.26 %, 9.26%, and 9.26%, respectively. CONCLUSION The incidence of nosocomial infections is high in the pediatric blood wards, the respiratory tract infections ranked the first place, the gram-negative bacteria are the predominant pathogens causing infections. It is necessary to put forward the targeted interventions so as to prevent and control the nosocomial infections in the pediatric ward.