Cavalcante Suzy Santana, Mota Eduardo, Silva Luciana Rodrigues, Teixeira Leonor Fernandes, Cavalcante Loíse Britto
Department of Pediatrics, Federal University of Bahia, Brazil.
Pediatr Infect Dis J. 2006 May;25(5):438-45. doi: 10.1097/01.inf.0000217377.54597.92.
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.
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 epidemiologic characteristics of NIs. Centers for Disease Control's standard definitions were used and the data recorded included intrinsic and extrinsic risk factors.
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 < 0.001) 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; P < 0.001).
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.
医院感染（NI）是儿科医院发病和死亡的重要原因。多种因素致使儿童在住院时面临感染风险，其中一些因素与成人不同。
这是一项于2003年1月至7月在巴西巴伊亚州萨尔瓦多的一家三级教学儿科医院开展的前瞻性研究，旨在描述医院感染的流行病学特征。采用了疾病控制中心的标准定义，记录的数据包括内在和外在风险因素。
我们评估了808例患者。124例患者发生了143次医院感染事件（15.4%）。医院感染病例的总体发病率为每1000患者日9.2例，1岁以下儿童（P < 0.001）和患有非手术临床疾病的儿童（P < 0.001）发病率更高。胃肠道感染（39.2%）和眼、耳、鼻、喉或口腔感染（29.4%）最为常见。与医院感染发病率较高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）以及入住儿科重症监护病房（IDR，3.5；95% CI，1.91 - 6.28）。有医院感染和无医院感染患者的住院时间分别为14.1天（标准差，20.5天）和5.1天（标准差，6.6天）（t = 121.76；P < 0.00）。
医院感染是儿科常见的并发症。它们不一定与侵入性操作有关，但肯定与一组在儿童年龄组具有特定特征的因素有关。
