Hernández Orozco Hilda, Lucas Resendiz Esperanza, Castañeda Jose Luis, De Colsa Agustin, Ramirez Mayans Jaime, Johnson Kyle M, Gonzalez Napoleon, Caniza Miguela A
*Department of Infectious Disease †Infection Prevention and Control Committee ‡Department of Gastroenterology, National Institute of Pediatrics, Mexico City, Mexico §Department of Infectious Diseases ∥The International Outreach Program, St. Jude Children's Research Hospital, Memphis, TN.
J Pediatr Hematol Oncol. 2014 Mar;36(2):96-8. doi: 10.1097/MPH.0b013e31827e7f4c.
Pediatric oncology and hematology patients are at increased risk of developing healthcare associated infections (HAIs). We conducted a prospective surveillance study on children with cancer admitted to the pediatric hematology and oncology units at a public pediatric hospital in Mexico from January 2004 to December 2009. The incidence of HAIs and groups at greatest risk for HAIs were analyzed. The annual HAI incidence rate and incidence density were calculated. Risk factors such as site of infection, HAI types, and cancer diagnosis were studied. A total of 9420 patients participated, and 409 had HAIs (479 episodes). Annual HAI rates were 3.7 to 5.5 per 100 admissions and the incidence density was 5.75 to 6 HAIs per 1000 inpatient days annually. There were 272 (56.8%) bloodstream infections, 45 (9.4%) pneumonia cases, and 44 (9.2%) skin and soft tissue infections. Children with acute lymphoblastic leukemia had 37.2% and those with acute myeloid leukemia had 16.4% of the HAIs. A total of 11.5% of the HAIs were in children with osteosarcoma. The most common pathogens were Gram-negative bacteria. The HAI-associated mortality rate was 3.7%. Although the overall HAI rate is in line with published reports, the mortality rate was higher, suggesting the incorporation of more aggressive methods to treat infections at our hospital.
儿科肿瘤学和血液学患者发生医疗保健相关感染（HAIs）的风险增加。我们对2004年1月至2009年12月在墨西哥一家公立儿科医院的儿科血液学和肿瘤学病房收治的癌症患儿进行了一项前瞻性监测研究。分析了HAIs的发生率以及发生HAIs风险最高的群体。计算了HAIs的年发病率和发病密度。研究了感染部位、HAIs类型和癌症诊断等风险因素。共有9420名患者参与，其中409名发生了HAIs（479次发作）。HAIs的年发病率为每100次入院3.7至5.5例，发病密度为每年每1000个住院日5.75至6例HAIs。有272例（56.8%）血流感染、45例（9.4%）肺炎病例和44例（9.2%）皮肤和软组织感染。急性淋巴细胞白血病患儿的HAIs占37.2%，急性髓细胞白血病患儿的HAIs占16.4%。骨肉瘤患儿的HAIs占11.5%。最常见的病原体是革兰氏阴性菌。HAIs相关死亡率为3.7%。虽然总体HAIs发生率与已发表的报告一致，但死亡率较高，这表明我院应采用更积极的方法治疗感染。
