Gastmeier P, Weigt O, Sohr D, Rüden H
Institute of Hygiene, Free University Berlin, Germany.
J Hosp Infect. 2002 Nov;52(3):161-5. doi: 10.1053/jhin.2002.1292.
The objective of the present study was to determine risk factors for development of the most common hospital-acquired infections in paediatric burn patients in order to give recommendations for surveillance. The prospective cohort study in a paediatric burn centre was conducted over a period of two years using uni- and multivariate analysis for risk factor identification. In a group of 41 children with an mean total burn surface area (TBSA) of 18.9% 42 hospital-acquired infections were observed. The overall infection rate was 59.7 nosocomial infections per 1000 patient days, the device-associated nosocomial infection rates per 1000 device days were 55.2 for pneumonia, 8.9 for primary bloodstream infections and 41.7 for urinary tract infections. The incidence density of burn wound infections was 18.5 per 1000 patient days. The percentage of TBSA was a significant risk factor for burn wound infections, but percentage of TBSA was not a risk factor for the device-associated infections. Duration of urinary catheter use and ventilation were identified as risk factors for the corresponding hospital-acquired infection. Surveillance of hospital-acquired infections in burn intensive care units should be performed in the same way as other intensive care unit types, as recommended by the National Nosocomial Infections Surveillance system, without consideration of the percentage of TBSA. In addition, burn wound infections should be recorded using the percentage of TBSA for stratification of burn wound infection rates.
本研究的目的是确定小儿烧伤患者最常见的医院获得性感染的危险因素，以便为监测提供建议。在一家小儿烧伤中心进行了为期两年的前瞻性队列研究，采用单因素和多因素分析来识别危险因素。在一组41名平均烧伤总面积（TBSA）为18.9%的儿童中，观察到42例医院获得性感染。总体感染率为每1000个患者日59.7例医院感染，每1000个器械日的器械相关医院感染率分别为：肺炎55.2例、原发性血流感染8.9例、尿路感染41.7例。烧伤创面感染的发病密度为每1000个患者日18.5例。TBSA百分比是烧伤创面感染的一个重要危险因素，但TBSA百分比不是器械相关感染的危险因素。导尿管使用时间和通气时间被确定为相应医院获得性感染的危险因素。烧伤重症监护病房的医院获得性感染监测应按照国家医院感染监测系统的建议，与其他类型的重症监护病房采用相同的方式进行，无需考虑TBSA百分比。此外，应使用TBSA百分比记录烧伤创面感染情况，以便对烧伤创面感染率进行分层。
