Jordan García I, Arriourtúa A Bustinza, Torre J A Concha, Antón J Gil, Vicente J C de Carlos, González C Téllez
Servicio de Cuidados Intensivos Pediátricos, Hospital Sant Joan de Déu, Esplugues, Barcelona, España.
Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Madrid, España.
An Pediatr (Barc). 2014 Jan;80(1):28-33. doi: 10.1016/j.anpedi.2010.09.010. Epub 2011 Jan 12.
Nosocomial infection (NI) is a common complication in paediatric critical care units (PICU), with an associated mortality up to 11%.
To describe NI epidemiology in the national PICU. To initiate an standard NI control measures to obtain paediatric incidence rates.
Multicentre prospective study from 1 to 31 march 2007. Centre Disease Control diagnosis and methodological criteria were used. It was specially analyzed NI related to invasive devices: central venous catheter (CVC), mechanical ventilation (MV), urinary catheter (UC).
There were recruited 300 patients from 6 PICU, with 17 NI episodes in 16 patients (5,3% from admitted). NI rates resulted in 13,8 infections/1000 patients-day. Middle age from infected patients was 2,31 years (± 3,43), 9 males. Risk factors were found in 7 cases. NI location was: catheter-related bloodstream infection in 7 patients (6,7/1000 days CVC), ventilator associated pneumonia in 4 (9,4/1000 MV days), urinary-tract infection associated with UC in 4 (5,5/1000 UC days), one case of primary bloodstream infection and one surgical site infection. Isolated microorganisms were: 9 gram negatives bacillus, 4 Candida, 2 plasmocoagulase negative staphylococcus, 1 Haemophilus and 1 Staphylococcus aureus. Seven isolations were resistant microorganisms. There weren't any died related to NI.
NI epidemiology was similar to published data in our near countries. NI surveillance, with a standardized method of analysis is essential to the NI correct manage.
医院感染（NI）是儿科重症监护病房（PICU）常见的并发症，相关死亡率高达11%。
描述全国PICU的NI流行病学情况。启动标准的NI控制措施以获得儿科发病率。
2007年3月1日至31日的多中心前瞻性研究。采用疾病控制中心的诊断和方法学标准。特别分析了与侵入性装置相关的NI：中心静脉导管（CVC）、机械通气（MV）、导尿管（UC）。
从6个PICU招募了300名患者，16名患者发生了17次NI事件（占入院患者的5.3%）。NI发生率为13.8例感染/1000患者日。感染患者的中位年龄为2.31岁（±3.43），男性9例。7例发现了危险因素。NI的部位为：7例患者发生导管相关血流感染（6.7/1000天CVC），4例发生呼吸机相关性肺炎（9.4/1000 MV日），4例发生与UC相关的尿路感染（5.5/1000 UC日），1例原发性血流感染和1例手术部位感染。分离出的微生物有：9株革兰氏阴性杆菌、4株念珠菌、2株凝固酶阴性葡萄球菌、1株嗜血杆菌和1株金黄色葡萄球菌。7株分离菌为耐药菌。没有与NI相关的死亡病例。
NI流行病学与我们周边国家公布的数据相似。采用标准化分析方法进行NI监测对于正确管理NI至关重要。
