台灣某兒童醫院1995－1999年間之院內感染調查分析

Nosocomial Infections in a Children's Hospital in Taiwan, 1995-1999

李欣倫(Hsin-Lun Lee) ； 邱月壁(Yueh-Pi Chiu) ； 蘇玲慧(Lin-Hui Su) ； 黃玉成(Yhu-Chering Huang) ； 呂學重(Hsieh-Shong Leu) ； 暨感染管制小組(Infection Control Group)

《院內感染控制雜誌》 12卷2期 (2002/04) Pp. 69-77

摘要

本院是台灣第一家兒童專科醫院，目前規模為522床。為瞭解其院內感染情形，以作為日後改進參考之用，針對近5無來院內感染調查資料提出分析。本院由1995年至1999年五年內總佔床人日數為727,660人次；院內感染個案總人次共2,485人次，感染千人日率平均為3.42‰。在感染部位方面，血流感染（47.95%） ，心血管系統中之動、靜脈感染（9.65%），眼耳鼻喉口部位感染（9.55%）。院內感染菌種排序依次為Staphylococcus aureus（25.88%）、coagulase-negative staphylococci（CoNS）（19.35%）、Escherichia coli（6.11%）。以感染部位的菌種分析，血流感染分別以CoNS、S. aureus為主，心血管系統感染則是以S. aureus、CoNS、Pseudomonas aeruginosa為主，眼耳鼻喉口感染則以S. aureus、CoNs及viridans streptococci為主。比較加護病房與普通病房各部位之菌種分佈並無明顯差異，加護病房第一位是S. aureus，而普通病房是CoNS。分析結果可知（1）院內感染菌種以革蘭氏陽性菌遠較革蘭氏陰性菌為多，其中又以S. aureus及CoNs最為重要，而S. aureus對oxacillin的抗藥性由1997年80.4 %增加至1999庫91.86%。（2）院內感染部位分佈以血流感染佔首位。（3）院內感染發生的區域以加護病房為主，佔總感染件數的75%以上。我們期待經由本調查能提供未來在兒科之臨床醫護人員照護及研究上能有所助益。

關鍵字

兒童醫院 ； 院內感染 ； 感染率

並列摘要

Chang Gung Children’s Hospital, located in northern Taiwan, is the first hospital in Taiwan specific for pediatric patient care. A review of the records between 1995 and 1999 showed that the most common mode of nosocomial infections was bloodstream infections (BSI) (47.95%), followed in the order of frequency by cardial vascular system (CVS) (9.65%), and ear-nose-throat (ENT) infections (9.55%). Staphylococcus aureus (25.88%), coagulase-negative staphylococci (CoNS) (19.35%), and Escherichia coli (6.11%) are the three major organisms that caused nosocomial infections in this hospital. The most common pathogen for each individual mode of infection was CoNS and S. aureus for BSI, S. aureus, CoNS, and Pseudomonas aeruginosa for CVS infections, and S. aureus, CoNS, and viridans streptococci for ENT infections. There was no difference in terms of the distribution of pathogens between ordinary wards and intensive care units. It appears that gram-positive bacteria were more common than the negatives in causing nosocomial infections in our hospital. Moreover, the prevalence of methicillin-resistant S. aureus has increased from 80.4% in 1997 to 91.86% in 1999. It is hopeful that the information obtained in this study would be of value to medial personnel who are responsible for the care of pediatric patients.

並列關鍵字

pediatric hospital ； nosocomial inections ； infection rate