2014年广州地区某儿童医院医院感染现患率

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。

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

ObjectiveTo investigate the prevalence of healthcare associated infection(HAI) in a children’s specialty hospital in Guangzhou in 2014.MethodsA cross sectional survey was undertaken to investigate the prevalence of HAI among all hospitalized patients on September 17, 2014.ResultsA total of 997 patients were investigated, 30 patients developed 32 times of HAI, HAI rate and HAI case rate were 3.01% and 3.21% 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, 6 of 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%.ConclusionManagement 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.