摘要
目的探讨儿科心脏重症监护病房(CICU)患儿发生导尿管相关性尿路感染(CAUTI)的感染特点及相关危险因素,为预防CAUTI发生提供有力依据。方法采用前瞻性研究,对2013年1月-2014年12月收入CICU的2 457例患儿发生CAUTI进行监测,并采用多因素logistic分析发生CAUTI的危险因素,数据采用SPSS 17.0软件进行统计分析。结果 2 457例患儿发生CAUTI 56例,感染率为2.28%,留置尿管总日数为9 021d,CAUTI千日感染率6.21/‰;从56例CAUTI患儿中共分离出62株病原菌,其中革兰阴性菌33株占53.23%,检出第1位的病原菌为大肠埃希菌;单因素方差分析显示,患儿体质量<6kg、年龄<6月龄、使用抗菌药物、留置尿管天数≥15d和住院天数>14d等为发生CAUTI的危险因素;多因素logistic分析显示,体质量<6kg和住院天数>14d为CICU患儿发生CAUTI的独立危险因素。结论 CICU患儿CAUTI感染率较高,特别是体质量<6kg患儿发生CAUTI的风险可增高3.58倍(P<0.001),应针对该类患儿制定相应措施,以有效降低CAUTI感染。
OBJECTIVE To investigate the characteristics and risk factors for catheter-associated tract infections（CAUTI）in cardiac intensive care unit（CICU）in pediatrics,so as to explore scientific and effective measures for infection control.METHODS The prospective study was performed on 2 457 patients with indwelling catheters between Jan.2013 and Dec.2014 in pediatric CICU.The multivariate logistic analysis was conducted on the risk factors of infections and the software SPSS17.0was used for statistical analysis.RESULTS A total of 2 457 patients were included in the study,there were 56 patients with CAUTI,the infection rate was 2.28%,the total day of catheter use were 9 021 d,the overall CAUTI incidence rate was 6.21‰.Totally 62 pathogens were isolated in56 patients with CAUTI,including 33gram-negative bacteria（53.23%）,Escherichia coli was the most common bacteria.The one-way ANOVA analysis showed weight less than 6kg,age less than 6months,use of antibacterial drugs,ventilator days,catheter days and central line days more than 7days and duration of hospital stay more than 14 days were risk factors of CAUTI.The multivariate logistic regression analysis showed weight less than6 kg and duration of hospital stay more than 14 days were independent risk factors of CAUTI.CONCLUSION There is high incidence of CAUTI in pediatric CICU,especially for those who weight under 6kg as there was 3.58 times higher possibility to have occurrence of CAUTI than those weight heavier（P〈0.001）.Clinicians should formulate effective measures special for these children in order to reduce the incidence of CAUTI in pediatric CICU.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第3期671-673,共3页
Chinese Journal of Nosocomiology
基金
广东省科技计划基金资助项目(2012B061700011)
广州市科技计划基金资助项目(2014Y2-00031)
