Raffaldi Irene, Scolfaro Carlo, Pinon Michele, Garazzino Silvia, Dalmasso Paola, Calitri Carmelina, Peretta Paola, Ragazzi Paola, Gaglini Pier Paolo, Pretti Pier Federico, Vitale Pasquale, Conio Alessandra, Tovo Pier-Angelo
Department of Pediatrics, Regina Margherita Children's Hospital, Turin, Italy.
Pediatr Neurosurg. 2011;47(4):261-5. doi: 10.1159/000335401. Epub 2012 Feb 3.
This prospective surveillance study was designed to estimate the incidence of healthcare-associated infections (HAIs) and to analyze the risk factors for their development in a pediatric neurosurgical unit.
The study was performed in an Italian teaching hospital from October 2008 through March 2010. All children (0-18 years) undergoing neurosurgery were included and monitored daily for the development of HAIs.
The study included 260 patients, with a mean age of 4.3 ± 4.7 years. Thirty-six HAIs were detected in 25 patients; catheter-related infections were the most frequent. Etiological identification was available in 22 cases; Gram-negative bacteria were the most commonly isolated pathogens. The incidence density was 11.0/1,000 patient days, and the incidence rate was 13.8/100 patients. The crude mortality was 0%. The risk of developing HAIs was related to the length of hospital stay, while the higher the age of the patients, the lower the risk of developing HAIs.
To our knowledge, this survey is the first study to evaluate the overall incidence of HAIs and to explore the risk factors implicated in their development in neurosurgical pediatric patients. The most effective strategies to prevent these infections are reduction of the length of the hospital stay and improvement in device management.
本前瞻性监测研究旨在估计医疗相关感染（HAIs）的发生率，并分析儿科神经外科病房中其发生的危险因素。
该研究于2008年10月至2010年3月在一家意大利教学医院进行。纳入所有接受神经外科手术的儿童（0 - 18岁），并每天监测HAIs的发生情况。
该研究纳入了260例患者，平均年龄为4.3±4.7岁。在25例患者中检测到36例HAIs；与导管相关的感染最为常见。22例病例有病原学鉴定结果；革兰氏阴性菌是最常分离出的病原体。发病密度为11.0/1000患者日，发病率为13.8/100患者。粗死亡率为0%。发生HAIs的风险与住院时间有关，而患者年龄越大，发生HAIs的风险越低。
据我们所知，本调查是第一项评估HAIs总体发生率并探讨儿科神经外科患者中其发生相关危险因素的研究。预防这些感染的最有效策略是缩短住院时间和改善器械管理。
