浙江大学医学院附属儿童医院2005年至2014年医院感染现状及变化趋势．  

Current status and trends of nosocomial infection in Zhejiang University affiliated Children＇s Hospital from 2005 to 2014

作　　者：吕华[1] 孙伟[1] 顾美虹[1] 吴秀英[1] 

机构地区：[1]浙江大学医学院附属儿童医院感染管理科,杭州310052

出　　处：《中华传染病杂志》2016年第9期524-529,共6页Chinese Journal of Infectious Diseases

摘　　要：目的了解儿童医院的医院感染现状及变化趋势，为医院感染防控重点提供参考依据。方法回顾性分析浙江大学医学院附属儿童医院2005年至2014年住院患儿医院感染资料。结果住院患儿共357684例次，发生医院感染13934例次，医院感染发生率为1．72％～5．80％，平均为3．90％。医院感染平均发生率前5位科室分别是血液科14．47％、新生儿重症监护病房（NICU）11．63％、外科重症监护病房（SICU）6．45％、消化内科4．52％和新生儿病房4．33％。2014年NICU、SICU的医院感染发生率升至第一、第二位，分别为17．55％和8．30％。全院医院感染部位分布上呼吸道36．79％、消化道22．76％、下呼吸道21．40％和败血症14．55％。2005年至2014年，上呼吸道感染逐年下降，从51．08％下降至15．78％；而下呼吸道感染和败血症呈逐年增加趋势，分别由15．92％升至35．92％和11．18升至22．50％；消化道感染在高水平波动。不同科室主要感染部位构成比不同：新生儿病房消化道感染占69．93％，血液科败血症占56．51％，NICU、SICU、JL童重症监护病房（PICU）及胸外科下呼吸道感染均超过60％。医院感染病原微生物分布中病毒占49．29％，革兰阴性菌占34．25％、革兰阳性菌占12．75％，真菌占3．14％，变化趋势不大。轮状病毒最常见，肺炎克雷伯菌、鲍曼不动杆菌其次，ICU多重耐药菌检出率逐年增加。结论儿童医院的医院感染发生率总体呈下降趋势，但NICU、SICU医院感染发生率逐年增加。下呼吸道感染、败血症构成比增加，ICU多重耐药菌检出率增加。轮状病毒仍是消化道感染最常见的病原微生物。Objective To investigate the status and trends of nosocomial infection in children＇s hospital to provide references for prevention and control of nosocomial infection. Methods The retrospective study were conducted to analyze the data of nosocomial infection at Zhejiang University affiliated Childrenls Hospital from 2005 to 2014. Results A total of 357 684 discharged patients were studied, nosocomial infection occurred in 13 934 cases. The mean infection rate was 3. 9% （1. 72%- 5.80%）. The ＇top five department of nosoeomial infection rate were the department of hematology （14.47%）, neonatal intensive care unit （NICU, 11.63%）, surgical intensive care unit （SICU, 6.45%） , gastroenterology （4.52%） and newborn nursery （4.33%）. The infection rate in NICU and SICU became the first and second place in 2014, which were 17. 55% and 8.30%, respectively. The clistributions of nosocomial infection site were upper respiratory tract infection （36.79%）, gastrointestinal tract infection （22.76%）, lower respiratory tract infection （21.40%） and sepsis （14.55%）. The proportion of upper respiratory tract infection had declined year by year from 51.08% to 15. 78%, while the proportion of lower respiratory tract infection and sepsis had increased from 15.92% to 35.92% and from 11. 18% to 22.50%, respectively. The proportion of gastrointestinal infections remained high. The constitution of infection sites in different departments were different. The digestive tract infection （69. 93%） were dominant in the department of neonatology, sepsis （56.51%） in the department of hematology, and the lower respiratory tract infection in NICU, SICU, PICU and cardiothoracic surgery departments were above 60%. Regarding the constitution of the pathogenic microorganisms, 49.29% were virus infection, 34.25% gram negative bacterial infection, 12. 75% gram positive bacterial infection and 3. 14% fungus infection with no remarkable changes. Rotavirus was the most common pathogen causing nosocomial infecti

关 键 词：医院感染 儿童医院 回顾 变化趋势 

分 类 号：R197.5[医药卫生—卫生事业管理]