广州地区患儿胃肠道医院感染流行特征

Epidemiological features of gastroenteritis among children in hospitals of Guangzhou

目的分析儿童专科医院住院患儿胃肠道医院感染分布特点,为采取针对性的干预措施提供参考依据。方法采用前瞻性研究,对2013年1月-2014年12月符合医院胃肠道感染住院患儿为研究对象,分析住院患儿胃肠道感染分布特点,数据采用SPSS16.0软件进行统计分析。结果调查期间住院患儿95 722例,医院感染2 332例,感染率2.44%;其中胃肠道感染342例占14.67%,多发生在住院后3d^1周占58.48%,其次为住院后第2周占26.61%,住院两周后感染率为14.91%;342例胃肠道医院感染患儿中送检标本307例,送检率89.78%,检出病原体248株,其中检出病毒228株占91.94%;至12月份病毒性感染比例可高达83.91%;病毒性胃肠道医院感染81.14%发生在≤24月龄患儿,而其他胃肠道感染占64.04%集中在≤18月龄患儿;病毒性感染主要发生在秋冬季,其他胃肠道医院感染无季节性趋势;胃肠道医院感染病例和病毒性感染病例均集中在呼吸内科、消化内科、感染病区和危重部综合病区。结论住院患儿胃肠道感染以病毒感染为主,有其自身特点,应针对性地采取干预措施,降低医院感染。

OBJECTIVE To analyze the epidemiological features of nosocomial gastroenteritis among children in hospitals of Guangzhou,so as to guide the targeted intervention to reduce the nosocomial infections.METHODS A prospective analysis was performed.The patients who were confirmed nosocomial gastroenteritis and hospitalized from Jan.2013 to Dec.2014,were analyzed in this study.SPSS 16.0 was adopted for statistical analysis.RESULTS Among 95 722 children in hospital,2 332 cases got infected and the infection rate was 2.44%.Among them,342 cases were confirmed as nosocomial gastroenteritis,accounting for 14.67%,in which 58.58% were infected at the hospital stays of the third day to the first week,followed by the second week（26.61%）and the longer（14.91%）.Totally 307 samples were inspected and the inspection rate was 89.78%.There were 248 strains of pathogens were detected,including 228 strains of virion,holding 91.94%,and the proportion increased and reached up to a peak of 83.91%in Dec.Of viral nosocomial gastroenteritis cases,81.14% occurred in children aged ≤24 months,however of other nosocomial gastroenteritis cases,64.04% occurred in children aged ≤18months.The peak season of viral nosocomial gastroenteritis was in fall and winter（October,November,December and January）,but there was no seasonal trend for other nosocomial gastroenteritis.More than half of nosocomial gastroenteritis cases and viral infection ones both occurred at the departments of respiration,gastroenterology,infectious diseases and critical care.CONCLUSIONThis study reveals that the major type of nosocomial gastroenteritis is viral infection with the special characters,and should be targeted to intervene to reduce the nosocomial infections.