Risk factors for developing nosocomial infections among pediatric patients
Risk factors for developing nosocomial infections among pediatric patients
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DOI：
10.1097/01.inf.0000217377.54597.92
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发表时间：
2006-05-01
影响因子：
3.6
通讯作者：
Silva, Luciana Rodrigues
中科院分区：
文献类型：
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作者：
Cavalcante, Suzy Santana;Mota, Eduardo;Silva, Luciana Rodrigues
背景：医院感染（NI）是儿科医院发病和死亡的重要原因。导致儿童住院时面临感染风险的因素有多种，其中一些因素与成人不同。 方法：这是一项前瞻性研究，于 2003 年 1 月至 7 月在巴西巴伊亚州萨尔瓦多市的一家三级教学儿科医院进行，旨在描述 NI 的表皮学特征。使用疾病控制中心的标准定义，记录的数据包括内在和外在危险因素。结果：我们评估了 808 名患者。 124 名患者（15.4%）共发生 143 次 NI 发作。 NI病例的总体发生率为9.2例/1000患者日，其中1岁以下儿童（P < 0.00 1）和患有非手术临床疾病的儿童（P < 0.001）发生率较高。胃肠道感染（39.2%）和眼、耳、鼻、喉或口腔感染（29.4%）最为常见。与NI较高发生率最密切相关的因素是入院时的呼吸系统疾病（发病密度比[IDR]，4.0；95%置信区间[CI]，2.83-5.72）、与入院诊断相关的另一种疾病（IDR，3.5；95% CI，2.41-5.02）、非手术临床疾病（IDR，5.9；95% CI， 3.92-8.85）和 儿科重症监护病房住院（IDR，3.5；95% CI，1.91-6.28）。有院内感染和无院内感染患者的住院时间分别为14.1天（SD，20.5天）和5.1天（SD，6.6天）（t = 121.76-1 P < 0.001）。结论：院内感染是儿科常见的并发症。它们不一定与侵入性操作有关，但肯定与一组在儿科年龄组中具有特定特征的因素有关。
Background: Nosocomial infections (NIs) are important causes of morbidity and mortality in pediatric hospitals. Multiple factors contribute towards exposing children to the risk of infection when hospitalized, and some of them differ from those in adults.Methods: This was a prospective study in a tertiary-level teaching pediatric hospital in Salvador, Bahia, Brazil, conducted from January to July, 2003, to describe the epidermologic characteristics of NIs. Centers for Disease Control's standard definitions were used and the data recorded included intrinsic and extrinsic risk factors.Results: We evaluated 808 patients. There were 143 episodes of NI in 124 patients (15.4%). The overall incidence of NI cases was 9.2 per 1,000 patient-days, with higher rates among children aged less than 1 year (P < 0.00 1) and those with nonsurgical clinical diseases (P < 0.001). Gastrointestinal infections (39.2%) and eye, ear, nose, throat or mouth infections (29.4%) were most common. The factors most closely associated with higher incidence of NI were respiratory disease on admission (incidence density ratio [IDR], 4.0; 95% confidence interval [CI], 2.83-5.72), another disease associated with admission diagnosis (IDR, 3.5; 95% CI, 2.41-5.02), nonsurgical clinical disease (IDR, 5.9; 95% CI, 3.92-8.85) and pediatric intensive care unit residence (IDR, 3.5; 95% CI, 1.91-6.28). The lengths of hospital stay for patients with and without nosocomial infection were, respectively, 14.1 days (SD, 20.5 days) and 5.1 days (SD, 6.6 days) (t = 121.76-1 P < 0.001).Conclusions: Nosocomial infections are a frequent complication in pediatrics. They are not necessarily related to invasive procedures but certainly are related to a group of factors that have particular characteristics in the pediatric age group.