2014年广州地区某儿童医院医院感染现患率

Prevalence of healthcare-associated infection in a children's hospital in Guangzhou in 2014

目的了解某儿童专科医院2014年医院感染现患情况。方法采用横断面调查的方法,调查广州某儿童医院2014年9月17日所有住院患者医院感染现患情况。结果共调查997例住院患者,发现医院感染30例、32例次,医院感染现患率3.01%、例次现患率3.21%。感染部位主要为上呼吸道(11例次,占34.38%);感染高发科室以重症监护病房(ICU,3.99%)和儿内科(3.60%)较高;医院感染患者病原学送检率为93.33%,共检出病原体24株,其中病毒、真菌各6株(各占25.00%),细菌11株(45.83%),衣原体1株(4.17%),细菌主要为金黄色葡萄球菌和表皮葡萄球菌(各3株,各占27.27%)。调查当日抗菌药物使用者451例,使用率为45.24%,其中以治疗用药为主(67.41%),预防用药和治疗+预防用药的比率分别为19.73%和12.86%;82.26%为单一用药,使用治疗性抗菌药物者(含治疗+预防用药)细菌培养送检率82.60%。结论儿童专科医院需加强重点科室、重点部位的医院感染管理,合理规范使用抗菌药物,保障患者安全。

Objective To investigate the prevalence of healthcare-associated infection（HAI）in a children＇s specialty hospital in Guangzhou in 2014.Methods A cross-sectional survey was undertaken to investigate the prevalence of HAI among all hospitalized patients on September 17,2014.Results A total of 997 patients were investigated,30 patients developed32 times of HAI,HAI rate and HAI case rate were 3.01%and3.21%respectively.The main infection sites were upper respiratory tract（n=11,34.38%）;the departments with higher HAI prevalence rates were intensive care unit（ICU,3.99%）and pediatric internal medicine department（3.60%）;the rate of etiological examination in patients with HAI accounted for 93.33%,a total of 24 strains of pathogens were isolated,6of which were virus（25.00%）,6 were fungi（25.00%）,11 were bacteria（45.83%）,and 1 was Chlamydia（4.17%）.The main bacteria were Staphylococcus aureus（n=3,27.27%）and Staphylococcus epidermidis（n=3,27.27%）;a total of 451（45.24%）patients received antimicrobial agents on the investigation day,67.41% of whom received therapeutic use of antimicrobial agents,19.73% received prophylactic use,and 12.86% received both therapeutic and prophylactic use;mono-drug application accounted for 82.26%,the percentage of bacterial detection among patients with therapeutic antimicrobial use（including combination of therapeutic and prophylactic use）was 82.60%.Conclusion Management of key departments and key sites of HAI should be strengthened in children＇s specialty hospital,antimicrobial agents should be used rationally,so as to protect the safety of children.