2014-2018年某院儿童血液肿瘤患者医院感染现患率调查

目的 了解儿童血液肿瘤患者医院感染现患情况，为有针对性的采取防控措施提供依据。方法 采用横断面调查方法，调查2014—2018年某儿童医院血液肿瘤科患者感染情况。结果 共调查553例血液肿瘤患者，医院感染现患率波动在13.51%~22.52%，平均18.08%。社区感染现患率波动在14.41%~21.62%，平均18.44%。各年龄段不同年度医院感染和社区感染现患率比较，以及不同年龄段医院感染和社区感染现患率比较，差异均无统计学意义（均P>0.05）；不同疾病类型中，再生障碍性贫血、急性淋巴细胞性白血病、实体瘤、淋巴瘤医院感染现患率分别为34.88%（15/43）、13.53%（28/207）、9.84%（12/122）、2.27%（1/44），不同疾病类型医院感染和社区感染现患率比较，差异均有统计学意义（χ²值分别为45.54、18.58，均P<0.05）。医院感染中，其他部位医院感染33例（33.00%），其中31例无明确定位，但有发热且抗感染治疗有效；分离细菌22株，病毒1株，革兰阴性菌占56.52%（13株）。结论 儿童血液肿瘤患者中，急性白血病和再生障碍性贫血患者感染风险大于实体瘤和淋巴瘤患者，应重点关注。应提升临床检验能力，提高感染定位和定性能力，有效防治医院感染。

Prevalence of healthcare-associated infection in children with hematological tumor in a hospital from 2014 to 2018

Objective To understand the current situation of healthcare-associated infection(HAI) in children with hematological tumor, and provide basis for targeted prevention and control measures. Methods A cross-sectional survey was conducted to investigate the infection of patients in the department of hematology oncology of a children's hospital from 2014 to 2018. Results A total of 553 patients with hematological tumor were investigated, the prevalence of HAI ranged from 13.51% to 22.52%, with an average of 18.08%, prevalence of community-associated infection(CAI) ranged from 14.41% to 21.62%, with an average of 18.44%. There were no significant differences between HAI rates and CAI rates of each age group in different years, as well as HAI rates and CAI rates of diffe-rent age groups (all P>0.05); of different types of diseases, HAI prevalence rates in patients with aplastic anemia, acute lymphocytic leukemia, solid tumor, and lymphoma were 34.88% (15/43), 13.53% (28/207), 9.84% (12/122), and 2.27% (1/44) respectively, HAI prevalence rates and CAI prevalence rates in patients with different diseases were both significantly different (χ²=45.54, 18.58, respectively, both P<0.05). Among HAI cases, 33 were other site infection (33.00%), 31 of which had no definite site, but had fever and received effective anti-infection treatment; 22 strains of bacteria and 1 strain of virus were isolated, gram-negative bacteria accounted for 56.52%(13 strains). Conclusion Infection risk of acute leukemia and aplastic anemia is higher than that of solid tumor and lymphoma in children with hematologic tumor, which should be paid more attention. It is necessary to improve the ability of clinical examination, ability of localization and determination of infection, effectively prevent and treat HAI.