PICU医院感染的临床分析及干预对策

Clinical analysis and intervention measures of hospital infections in the pediatric intensive care unit

目的探讨儿科重症监护病房(PICU)医院感染的临床特点并针对性提出干预对策,以降低医院感染的发生率。方法将2012年3-12月医院ICU收治的326例患儿为研究对象,对其临床资料进行回顾性分析,数据采用SPSS 15.0进行分析。结果 326例患儿中发生医院感染39例,感染率为11.96%;感染部位以下呼吸道感染为首位占35.89%;引起医院感染最多的疾病是败血症、脓毒症,占25.64%;引起医院感染的病原菌以不动杆菌属最多,占26.42%;易感因素包括住院时间过长、接受侵入性操作及长期联合使用抗菌药物等。结论 PICU医院感染发生概率较高,应加强PICU人员、环境及物品管理,严格消毒隔离制度、严格执行无菌操作、合理使用抗菌药物、尽量缩短住院时间等,以降低医院感染的发生率。

OBJECTIVE To explore the clinical features of hospital infections in the pediatric intensive care unit （ICU） and propose some specific care policies in order to control hospital infections. METHODS The 326 sick children admitted to the pediatric ICU of our hospital during Mar. 2012 to Feb. 2013 were studied, and their clinical data were retrospectively analyzed with SPSS 15.0. RESULTS There were 39 hospital infections among the 326 children and the incidence of hospital infections was 11.96%; the lower respiratory infection was the most in the distribution of infection sites （35.89%） ; septicemia and sepsis were the most common diseases to induce hospital infections （25.64%）; Acinetobacters were the predominant pathogens leading to hospital infections （26.42%）. The susceptible factors included long stay in hospital, adoption of invasive procedures and long-term use of combined antibiotics. CONCLUSION The incidence of hospital infections in pediatric ICU is high. In order to control hospital infections, certain measures should be taken： the environmental management of the ICU ward should be intensified, strict disinfection and isolation system should be performed, as well as strict aseptic manipulation, rational use of antibiotics, and reduce of the length of hospital stays.