某妇幼专科医院儿童血液病医院血流感染相关危险因素及病原菌分析  

Analysis of the risk factors and distribution of pathogenic bacteria associated with nosocomial bloodstream infection with hematopathy in children in a maternal and child specialist hospital

作　　者：何琛[1] 胡曦尹 孟令恒 张渝侦 张万鸿 He Chen;Hu Xiyin;Meng Lingheng;Zhang Yuzhen;Zhang Wanghong(Administration Department of Nosocomial Infection,Guiyang City Maternal and Child Health Care Hospital,Guiyang 550001,Guizhou,China;Department of Pediatric Hematology,Guiyang City Maternal and Child Health Care Hospital,Guiyang 550001,Guizhou,China)

机构地区：[1]贵阳市妇幼保健院医院感染管理科,贵州贵阳550001 [2]贵阳市妇幼保健院儿童血液科,贵州贵阳550001

出　　处：《贵州医药》2024年第10期1533-1538,1543,共7页Guizhou Medical Journal

摘　　要：目的对儿童血液病医院血流感染相关危险因素及病原菌分布情况进行分析,为临床风险识别及早期干预提供理论依据,进一步减少儿童血液病患儿医院血流感染的发生。方法采取病历调阅结合院感实时监控系统的方式,调查2018年1月至2022年12月期间该院收治血液病住院患儿共5259例。结果医院血流感染95例,感染率1.81%;血管导管相关血流感染5例(5.26%)。革兰氏阳性菌48株(50.53%),主要为草绿色链球菌及表皮葡萄球菌;革兰氏阴性菌45株(47.37%),主要为大肠埃希菌及肺炎克雷伯菌;真菌2株(2.10%),均为白色假丝酵母菌。革兰氏阴性菌占比呈现逐渐增加的趋势。95株病原菌中,多重耐药菌40株(42.11%)。恶性血液病、骨髓抑制、输血、中心静脉置管及住院时间>7 d是儿童血液病患儿发生医院血流感染的危险因素。结论应对儿童血液病患儿医院血流感染危险因素、病原菌类型及耐药情况进行实时监控、早期识别及风险评估;根据风险评估结果,采取合适及有效的感染防控措施,预防医院血流感染发生。Objective To analyze the risk factors and distribution of pathogenic bacteria associated with nosocomial bloodstream infection with hematopathy in children,and provide a theoretical basis for clinical risk identification and early intervention,and to further reduce the occurrence of nosocomial bloodstream infection with hematopathy in children.Methods The total of 5,259 inpatients with hematologic diseases were investigated by taking the approach of medical record investigation combined with real-time monitoring system of nosocomial infection from January 2018 to December 2022.Results 95 cases of nosocomial bloodstream infection,the infection rate was 1.81%,5 cases(5.26%)of catheter-related bloodstream infection(CRBSI).There were 48 strains of Gram-positive bacteria(50.53%),mainly Streptococci viridans and Staphylococcus epidermidis.45 strains of Gram-negative bacteria(47.37%),mainly Escherichia coli and Klebsiella pneumoniae.2 strains of fungi(2.10%),both were Candida albicans.The proportion of gram-negative bacteria showed a gradually increasing trend.40 strains(42.11%)of multi-drug resistant organism(MDRO)were among the 95 strains of pathogenic bacteria.Hematologic malignancies,myelosuppression,blood transfusion,central venous catheters and hospitalization time>7 days were risk factors of nosocomial bloodstream infection with hematopathy in children.Conclusion Real-time monitoring,early identification and risk assessment of risk factors of nosocomial bloodstream infection with hematopathy in children,types and drug resistance of pathogenic bacteria should be carried out.Based on the results of risk assessment,appropriate and effective infection prevention as well as control measures are taken to prevent the occurrence of nosocomial bloodstream infection.

关 键 词：儿童血液病 医院血流感染 危险因素 病原菌 多重耐药 感染防控 

分 类 号：R552[医药卫生—血液循环系统疾病]