OBJECTIVE To analyze the characteristics of infected cases including infection sites and time, distribution in clinical departments, susceptible populations and pathogenic microorganisms in children′s specialized hospitals, and to provide references for prevention and control of hospital-associated infections.
METHODS Data on inpatients and patients with hospital-acquired infections (HAI) in a children′s specialized hospital were collected from 2018 to 2022, including age, gender, main diagnosis at discharge, department admitted, underlying diseases, infection sites, length of hospital stay and microbiological results. The incidence rate of HAI (cases per episode) and the daily incidence rate of HAI (cases per day) were used to describe the occurrence.
RESULTS The incidence rate of HAI was 0.83% (2 706/326 074), with an average hospital stay of 28.29 days. The median age was 3.17 (1.08, 7.42) years. The incidence rates for the age groups 0-28 days, 29 days- < 1 year, 1- < 3 years, 3- < 7 years, 7- < 13 years and 13-18 years were 1.40%, 1.73%, 1.12%, 0.67%, 0.59% and 0.50%, respectively, with statistically significant differences (P=0.001). The top five HAI sites were: bloodstream, upper and lower respiratory tract, gastrointestinal and urinary tract infections, with a cumulative percentage of 87.94%. The incidence rate of each site in departments of internal medicine was higher than that in departments of surgery (P=0.001). Bloodstream and lower respiratory tract infections were mainly caused by bacteria such as Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa; upper respiratory tract and gastrointestinal infections were mainly caused by viruses such as influenza virus, rotavirus, and norovirus. Totally 71.99% of HAI occurred within the first 14 days of hospitalization, and differences of infection time existed in various specialties with statistical significance (P < 0.001).
CONCLUSIONS The incidence rate of HAI in children specialized hospitals is lower than that reported in other domestic and international studies, and special attention should be paid to patients under 1 year of age owning to their higher HAI risk. Acquired viral infections are common in children′s hospital, which are consistent with community, that vaccination and health education should be promoted. Prolonged hospitalization increases the risk of HAI. Fourteen days before hospitalization is a high-risk period for HAIs, which should be paid more attention.
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