儿科门诊感染的临床特点及医护人员职业防护研究

Clinical characteristics of infections in pediatric clinic and occupational protection of health care workers

目的研究儿科门诊感染的临床特点以及医护人员的职业防护办法，以期为临床提供参考依据。方法选取2012年10月-2013年1月儿科门诊患儿6250例，回顾性分析其临床资料，分析感染例数、感染部位及病原菌分布，并制定职业防护措施。结果6250例门诊患儿中，感染5059例，感染率80．94％；感染患儿各年龄段的分布较为均衡，≤1岁占21．13％，1～3岁占22．30％，3～6岁占26．47％，≥6岁占30．10％；感染部位以下呼吸道为主，占54．38％，其次为上呼吸道和消化道，分别占9．37％和8．60％；5059例门诊感染患儿中罹患非传染性疾病的有4540例占89．74％，以上呼吸道感染居多，占44．67％，急性支气管炎次之，占19．02％；罹患传染性疾病的有519例占10．26％，以腹泻居多，占3．00％；5059例门诊感染患儿分离出病原菌6102株，前3位病原菌依次为凝固酶阴性葡萄球菌、大肠埃希菌、金黄色葡萄球菌，分别占32．40％、13．31％、7．40％。结论儿科门诊感染率较高，其中以下呼吸道感染最多；以罹患非传染性疾病为主，尤以上呼吸道感染最多；感染菌以凝固酶阴性葡萄球菌为主，应在门诊治疗中加强预防。

OBJECTIVE To study the clinical characteristics of infections in pediatric clinic and put forward measures for occupational protection of the health care workers so as to provide guidance for clinical treatment. METHODS A total of 6 250 children who were treated in the pediatric clinic from Oct 2012 to Jan 2013 were enrolled in the study, then the clinical data of the children were retrospectively analyzed, the number of cases of infections, infection sites, and distribution of pathogens were analyzed, and the measures for occupational protection were formulated. RESULTS The infections occurred in 5 059 of 6 250 children, with the infection rate of 80.94%. Among the children with infections, the children with no more than one year old accounted for 21.13%, the children with the age varying from one to three years old 22.30%, the children with the age varying from three to six years old 26.47%, the children with the age no less than six years old 30.10%. The children with lower respirato- ry tract infections accounted for 54.38%, the children with upper respiratory tract infections 9.37 M, the children with gastrointestinal tract infections 8.60%. Of the 5 059 children with infections, 4 540 suffered from non-infective diseases, accounting for 89.74%, the children with upper respiratory tract infections accounted for 44.67%, followed by the children with acute bronchitis （19.02%）; there were 519 （10.26%） children who suffered from the infective diseases, among whom the children with diarrhea accounted for 3.00%. Totally 6 102 strains of pathogens have been isolated form the 5 059 children with infections; the coagulase-negative Staphylococcus, Escherichia coli, and Staphylococcus aureus ranked the top three species of pathogens, accounting for 32.40%, 13.31%,and 7.40 %, respectively. CONCLUSION The incidence of infections is high in the pediatric clinic, and the lower respiratory tract infections are the most common. The children who suffer from the non-infective diseases are dominantl the coagulase-negative Staphylococcus is the predominant species of pathogensl it is necessary to strengthen the prevention during the treatment.