Jackowska Teresa, Pawlik Katarzyna
Klinika Pediatrii, Centrum Medyczne Kształcenia Podyplomowego, Warszawa. Kliniczny Oddział Pediatryczny, Szpital Bielański, Warszawa.
Dev Period Med. 2015 Apr-Jun;19(2):225-34.
Patients pediatric wards are particularly at risk of nosocomial infections. Therefore, the newest principles of prevention of infections should be implemented and monitored.
The study involved 4432 children hospitalized from October 2007 to December 2009 and 57 medical staff (doctors, nurses, orderlies). The effectiveness was assessed of prevention procedures for nosocomial infections and morbidity, and of vaccination against influenza among the sta$, as dened by the Act on the prevention and suppression of infection and infectious diseases human and the criteria developed by the Centers for Disease Control and Prevention.
Nosocomial infections were diagnosed in 2.2% of hospitalized children, where 96% were of acute gastroenteritis; 3% were bloodstream infections associated with peripheral vascular catheter. The 1% had respiratory infections (influenza). Hospital gastrointestinal infections were caused by the rotavirus (78%), norovirus (13%) and adenovirus (0.9%). In 1.1% of cases the etiology had not been determined. As a result of implementing prophylactic activities, a statistically significant reduction of the incidence of nosocomial infections by the rotavirus was achieved (from 7.1 to 1.5%). The occurrence catheter-related bloodstream infections was entirely eliminated. Influenza and influenza-like infections were reported in 7% of the medical staff in the season of 2009/2010 and 5% in the season of 2010/2011. 42% of the medical staff was immunized against the influenza (92% of doctors, 7% nurses, 0% orderlies).
The most common cause of nosocomial infections in the pediatric ward are rotaviruses. Rotavirus infections and catheter-related bloodstream infections are possible to be effectively prevented through regular, proactive preventive measures. Vaccinations of the medical sta$ against influenza medical staff against influenza still require implementing measures of a promotional and educational character.
儿科病房的患者尤其容易发生医院感染。因此,应实施并监测最新的感染预防原则。
1)确定住院患者医院感染的患病率、病因及临床表现;2)评估旨在预防医院轮状病毒感染和导管相关血流感染的措施的有效性;3)分析在甲型H1N1流感流行的连续两个季节(2009/2010年和2010/2011年)医护人员中流感的发病率;4)推广医护人员接种疫苗。
该研究纳入了2007年10月至2009年12月期间住院的4432名儿童以及57名医护人员(医生、护士、勤杂工)。根据《预防和控制人类感染及传染病法》以及美国疾病控制与预防中心制定的标准,评估了医院感染预防措施和发病率预防措施以及医护人员流感疫苗接种的有效性。
2.2%的住院儿童被诊断为医院感染,其中96%为急性胃肠炎;3%为与外周血管导管相关的血流感染。1%为呼吸道感染(流感)。医院胃肠道感染由轮状病毒(78%)、诺如病毒(13%)和腺病毒(0.9%)引起。1.1%的病例病因未明确。通过实施预防措施,轮状病毒引起的医院感染发病率在统计学上显著降低(从7.1%降至1.5%)。与导管相关的血流感染的发生完全消除。2009/2010年季节,7%的医护人员报告发生流感及流感样感染,2010/2011年季节为5%。42%的医护人员接种了流感疫苗(92%的医生、7%的护士、0%的勤杂工)。
儿科病房医院感染最常见的原因是轮状病毒。通过定期、积极的预防措施,可以有效预防轮状病毒感染和与导管相关的血流感染。医护人员流感疫苗接种仍需采取宣传和教育措施。