综合医院儿科病房医院感染现状及危险因素分析

Risk factors for nosocomial infections in wards of pediatrics department of general hospitals

目的分析综合医院儿科病房医院感染临床特征及危险因素,为临床治疗提供参考依据。方法采用回顾性调查的方法,对2012年4月-2013年3月住院的1 039例患儿临床资料进行研究;采用SASV8软件进行统计分析,组间计数资料采用χ2检验。结果 1 039例患儿中发生医院感染59例,感染率5.68%;感染部位以上呼吸道为主,占71.19%;其次为皮肤软组织、下呼吸道和泌尿道,分别占15.25%、11.86%、1.69%;不同年龄阶段的患儿医院感染率不同(χ2=12.4193,P<0.01),<1岁患儿医院感染率10.45%,是发生医院感染的高危人群;不同季节医院感染率差异有统计学意义(χ2=6.5246,P<0.05);冬季医院感染率10.94%,是医院感染的最高危季节;住院时间延长增加医院感染的风险,不同住院时间组患儿医院感染率差异有统计学意义(χ2=96.7125,P<0.05);居住大房间患儿医院感染率高于小房间住院患儿(χ2=5.0536,P<0.05)。结论年幼患儿、住院时间延长、住院环境是医院感染的危险因素,呼吸道疾病流行在冬季,是医院感染的高发季节,应针对上述危险因素进行及时干预,预防医院感染的发生。

OBJECTIVE To observe the clinical characteristics of nosocomial infections in wards of pediatrics depart- ment of general hospitals and analyze the risk factors so as to provide guidance for clinical treatment. METHODS By means of retrospective survey, the clinical data of 1 039 children who were hospitalized from Apr 2012 to Mar 2013 were analyzed, then the statistical analysis was performed with the use of SASV8 software, and the count data were analyzed by using chi-square test. RESULTS Of the 1 039 children, the nosocomial infections occurred in 59 cases with the infection rate of 5.68 %, among which the children with upper respiratory tract infections ac- counted for 71.19 %, the children with skin and soft tissue infections 15.25 %, the children with lower respiratory tract infections 11.86 %, the children with urinary tract infections 1.69%. The incidence of nosocomial infections varied in different age groups of children （x2 = 12. 4193,P〈0.01）, and the children aged less than one year were the population at the highest risk of nosocomial infections with the incidence of nosoeomial infections of 10.45 %. The incidence of nosocomial in.fections showed significant difference between the seasons （x2= 6. 5246 ,P〈0.05）, and the incidence of nosocomial infections was the highest （10.94%） in the winter. The prolonged hospital stay could increase the risk of nosocomial infections, and the difference in the incidence of nosocomial infections among the children with different lengths of hospital stay was significant （x2 = 96. 7125 ,P〈0.01）. The incidence of noso- comial infections was significantly higher in the children who lived in big rooms than in those who lived in small rooms （x2 = 5. 0536,P〈0.05）. CONCLUSION The young age, prolonged length of hospital stay, and hospitaliza- tion environment are the risk factors for nosocomial infections. The winter,in which the respiratory tract diseases are prevalent, is the peak season of occurrence of nosocomial infections.