某儿童专科医院住院患儿医院感染特点及危险因素

目的了解某儿童专科医院住院患儿医院感染特点及其危险因素，为医院感染的防控提供依据。方法对2013年1月1日-12月31日该儿童专科医院所有住院患儿的临床资料进行回顾性调查分析。 结果共调查住院患儿22 458例，其中男性患儿14 494例（64.54%），女性患儿7 964例（35.46%）；发生医院感染294例，医院感染率为1.31%(男性患儿1.16%，女性患儿1.58%)；医院感染率较高，居前3位的基础疾病是白血病(5.78%)、其他恶性肿瘤(4.01%)和泌尿系统疾病(3.40%)；感染部位以上呼吸道(33.22%)、胃肠道(24.67%)和下呼吸道 (23.03%)为主。医院感染单因素分析结果显示:年龄≤3岁、住院时间＞7 d、入住重症监护病房（ICU）/新生儿重症监护室（NICU）、抢救，以及使用抗菌药物是男女患儿医院感染的危险因素（均P＜0.01）。多因素非条件logistic回归分析结果显示：住院时间＞7 d、春冬季节患病、有过抢救，以及使用过抗菌药物是男患儿医院感染的独立危险因素；年龄≤3岁、住院时间＞7 d、接受过手术/侵入性操作，以及使用过抗菌药物是女患儿医院感染的独立危险因素。结论某儿童专科医院全年医院感染率较低，且存在性别差异，今后可根据患儿不同临床特征建立分级医院感染控制体系。

Characteristics and risk factors of healthcare associated infection in hospitalized children in a children’s hospital

ObjectiveTo understand the characteristics and risk factors of healthcare associated infection(HAI) in hospitalized children in a children’s hospital, so as to provide reference for prevention and control of HAI. MethodsClinical data of all hospitalized children in this hospital between January 1 and December 31, 2013 were analyzed retrospectively. ResultsA total of 22 458 hospitalized children were investigated, 14 494（64.54%）were male children，and 7 964（35.46%）were female children；294 cases of HAI occurred, HAI rate was 1.31%(male 1.16%， female 1.58%)；the top three underlying diseases in children with infection were leukemia（5.78%）, other malignant tumors（4.01%）, and urinary system diseases（3.40%）; the major infection sites were upper respiratory tract (33.22%), gastrointestinal tract (24.67%), and lower respiratory tract (23.03%). Univariate analysis showed that risk factors for HAI in male and female children were age ≤3 years old, length of hospital stay >7 days, stay in intensive care unit/ neonatal intensive care unit, being rescued, and antimicrobial use (all P<0.01). Multivariate non conditional logistic regression analysis showed that independent risk factors for HAI in male children were length of hospital stay>7 days, onset of disease in spring and winter season, being rescued, and antimicrobial use; independent risk factors for HAI in female children were age≤3 years old, length of hospital stay＞7 days, underwent surgery / invasive operation, and antimicrobial use. ConclusionHAI rate in the children’s hospital is low, and there are gender differences, HAI control system can be established according to the different clinical features of children.