Kinnula S E, Renko M, Tapiainen T, Knuutinen M, Uhari M
Department of Paediatrics, University of Oulu, Oulu, Finland.
J Hosp Infect. 2008 Apr;68(4):334-40. doi: 10.1016/j.jhin.2008.02.004. Epub 2008 Mar 21.
Viruses are important causes of paediatric hospital-associated infections (HAIs). We evaluated the frequency of viral HAIs during hospitalisation and after discharge in a paediatric infection ward. Data were collected prospectively for two years with follow-up questionnaires in which parents reported symptoms of new infections. Infections occurring >72 h after admission to hospital or <72 h after discharge were regarded as hospital-associated. The mean age of patients was 3.0 years and the mean hospitalisation time 3.0 days. Twenty-one out of the 1927 patients [1.1%, 95% confidence interval (CI): 0.7-1.7] developed an HAI during hospitalisation, in every case diarrhoea. A total of 1175 (61%) questionnaires were returned. In all, 86 children (7.3%, 95% CI: 5.9-9.0) had new symptoms within 72 h of discharge, most often diarrhoea (49%). Older age protected against HAI [odds ratio (OR, per year in age): 0.92; 95% CI: 0.85-0.99; P=0.02]. Among the patients hospitalised for respiratory infections, a shared room increased the risk of HAI (OR: 2.3; 95% CI: 1.1-4.8; P=0.03). Eight percent of the patients in our ward, where alcohol hand gel is actively used and single rooms are common, developed an HAI. Eighty percent of the HAIs appeared at home, which emphasises the importance of post-discharge follow-up.
病毒是儿童医院获得性感染（HAIs）的重要病因。我们评估了一家儿科感染病房住院期间及出院后病毒HAIs的发生频率。前瞻性收集了两年的数据，并通过随访问卷让家长报告新感染的症状。入院后>72小时或出院后<72小时发生的感染被视为医院相关感染。患者的平均年龄为3.0岁，平均住院时间为3.0天。1927例患者中有21例（1.1%，95%置信区间（CI）：0.7 - 1.7）在住院期间发生了HAI，均为腹泻。共收回1175份（61%）问卷。总计86名儿童（7.3%，95% CI：5.9 - 9.0）在出院后72小时内出现新症状，最常见的是腹泻（49%）。年龄较大可预防HAI（优势比（OR，每岁）：0.92；95% CI：0.85 - 0.99；P = 0.02）。在因呼吸道感染住院的患者中，共用病房会增加HAI的风险（OR：2.3；95% CI：1.1 - 4.8；P = 0.03）。在我们积极使用酒精洗手液且单人病房常见的病房中，8%的患者发生了HAI。80%的HAI出现在家中，这凸显了出院后随访的重要性。
