毛细支气管炎患儿医院感染的病原学与抗感染治疗效果  

Pathogenic and anti-infective effects on treating nosocomial infections in children with bronchiolitis

作　　者：张季红[1] 张晓英[1] 孙光辉[1] 朱翠翠[1] 常忠生[2] 

机构地区：[1]新疆医科大学第一附属医院儿科,新疆乌鲁木齐830054 [2]上海市第七人民医院肛肠科,上海200137

出　　处：《中华医院感染学杂志》2016年第11期2587-2589,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81060072)

摘　　要：目的分析临床毛细支气管炎患儿医院感染的病原体分布及相关危险因素,观察抗感染治疗效果,以降低医院感染率。方法选择2013年6月-2015年9月医院收治的1 343例毛细支气管炎患儿为研究对象,采集患儿鼻腔分泌物进行细菌培养,分析医院感染患儿的病原体分布及相关影响因素,对医院感染患儿给予分房及抗感染等治疗,治疗1周后评价临床疗效。结果 1 343例毛细支气管炎患儿发生医院感染147例,感染率为10.95%,其中病毒感染115例占78.23%,细菌感染32例占21.77%;经多因素logistics分析显示,住院时间>20d和早产儿是毛细支气管炎患儿发生医院感染的危险因素(OR=1.35,3.29;P<0.05),年龄>6月龄是其保护因素(OR=0.77,P<0.05);治疗期间医院感染患儿临床主要表现为肺部喘憋与哮鸣音,经分房及抗感染等治疗后有效率为97.96%。结论毛细支气管炎患儿发生医院感染临床主要表现为肺部喘憋与哮鸣音,临床应预防早产、年龄小及住院时间长的毛细支气管炎患儿发生医院感染,及时对发生感染的患儿进行分房及抗感染治疗效果显著。OBJECTIVE To analyze the distribution and risk factors of nosocomial infections in children with bronchiolitis,and observe the effect of anti-infection treatment,so as to reduce the hospital infection rate.METHODS A total of 1343 cases of children with bronchiolitis in hospital from Jun.2013 to Sep.2015 were selected as the research objects.Their nasal secretions were collected to perform the bacterial culture,and the types of pathogens and the risk factors of nosocomial infections were analyzed.Children with bronchiolitis complicated with nosocomial infections were separated in different wards and treated with anti-infection therapy,the clinical effect was evaluated after 1week of treatment.RESULTS Totally 147 cases of children occurred nosocomial infections among 1343 cases,the infection rate was 10.95%,among which there were 115 cases of viral infections,accounting for78.23%,and 32 cases of pathogenic bacteria infections,accounting for 21.77%;multi-factor logistics regression analysis showed that hospital stay time〉20d,premature infants were the risk factors causing nosocomial infections in the children with bronchiolitis（OR=1.35,3.29;P〈0.05）,and the age〉6months was the protect factor（OR=0.77,P〈0.05）.Pulmonary wheezing and wheezing rale were the mainly clinical characteristics during treatment,and the effective rate was 97.96%.CONCLUSION Pulmonary wheezing and wheezing rale are the mainly clinical characteristics for children with bronchiolitis complicated with nosocomial infection.We should pay attention to the infants with premature,younger and long hospital stay time and take measures to prevent them from the nosocomial infection in clinical practice,and promptly separating ward and anti-infection treatment has a good effect in treatment of nosocomial infections in children with bronchiolitis.

关 键 词：毛细支气管炎 患儿 医院感染 病原体 分布 危险因素 抗感染治疗 

分 类 号：R725.6[医药卫生—儿科]