Çocuklarda Nozokomiyal Enfeksiyonlar İçin Risk Faktörleri

Abstract

ABSTRACT Aim: To determine the frequency of nosocomial infections developed within a year in patients admitted to a tertiary pediatric hospital. Materials and Method: The patients who have been hospitalized at Dr Sami Ulus Children Hospital in a one-year period between February 1996 - February 1997 and diagnosed ‘nosocomial infection’ during their follow up were included in this study. The ‘nosocomial infection’ diagnosis used was based on Center for Disease Control (CDC) diagnostics criteria. Clinical findings were recorded besides laboratory and imaging data. Results In one-year period under consideration, a total number of 3420 patients were hospitalized. Nosocomial infection was detected in 9.1% (n=311) of these patients. 28.6% (n=89) of them were acute gastroenteritis, 23.4% (n=73) were urinary tract infection and 25.4% (n=79) were sepsis. The most common etiologic agents were K. pneumoniae (%40.3), Salmonella spp. (%43.0) and E. coli (%13.4). 77.8% of the patients with nosocomial infection were younger than one year old. In patients with urinary tract infection, 28.7% had urethral catheterization. Nosocomial infection was being observed after 16.9±10 days of hospitalization. 12.2% (n=38) of the patients with nosocomial infection have died. Inadequacy of professional staff, insufficient number of nurses per patient and failures in hand washing were thought to be the risk factors in the development of nosocomial infection. Conclusion: Nosocomial infection is an important cause for mortality and morbidity in pediatrics clinics. The most important steps in the efforts to decrease nosocomial infection frequency may be listed as the surveillance, detection of the problems and taking corresponding precautions to take the nosocomial infection under control. Keywords: Nosocomial infection; Child; Risk factors. ÖZ Amaç: Üçüncü basamak çocuk hastanesine bir yıl içinde başvuran hastalarda gelişen hastane enfeksiyonlarının sıklığını belirlemek. Gereç ve Yöntem: Dr. Sami Ulus Çocuk Hastanesi'nde Şubat 1996 - Şubat 1997 tarihleri arasındaki bir yıllık sürede, yatarken ve takiplerinde 'hastane enfeksiyonu' tanısı alan hastalar çalışmaya dahil edildi. Kullanılan "nozokomiyal enfeksiyon" tanısında, Center for Disease Control (CDC) tanı kriterleri temel alındı. Laboratuvar ve görüntüleme verilerinin yanı sıra klinik bulgular da kaydedildi. Sonuçlar İncelenen bir yıllık dönemde toplam 3420 hasta hastaneye yatırıldı. Bu hastaların %9,1'inde (n = 311) hastane enfeksiyonu tespit edildi. Bunların %28,6'sı (n = 89) akut gastroenterit, %23,4'ü (n = 73) idrar yolu enfeksiyonu ve %25,4'ü (n = 79) sepsis idi. En sık karşılaşılan etiyolojik ajanlar K. pneumoniae (%40,3), Salmonella spp. (%43,0) ve E. coli (%13,4) idi. Hastane enfeksiyonu olan hastaların %77,8'i bir yaşından küçüktü. İdrar yolu enfeksiyonu olan hastaların %28,7'sinde üretral kateterizasyon vardı. Hastanede yatışın 16.9 ± 10 gününde nozokomiyal enfeksiyon geliştiği görüldü. Hastane enfeksiyonu olan hastaların %12,2'si (n = 38) kaybedildi. Uzman personel yetersizliği, hasta başına düşen hemşire sayısı ve yeterli el yıkamamanın nozokomiyal enfeksiyon gelişiminde risk faktörleri olduğu düşünülmüştür. Sonuç: Hastane enfeksiyonu pediatri kliniklerinde önemli bir mortalite ve morbidite nedenidir. Hastane enfeksiyonu sıklığını azaltma çabalarında en önemli adımlar, nozokomiyal enfeksiyonun kontrol altına alınması için sürveyans, sorunların tespiti ve buna uygun önlemlerin alınması olarak sıralanabilir. Anahtar Kelimeler: Nozokomiyal enfeksiyon, Çocuk, Risk faktörleri.

Keywords

• nozokomiyal enfeksiyon
• çocuk
• risk faktörleri

Risk Factors for Nosocomial Infections in Children

Abstract

ABSTRACT Aim: To determine the frequency of nosocomial infections developed within a year in patients admitted to a tertiary pediatric hospital. Materials and Method: The patients who have been hospitalized at Dr Sami Ulus Children Hospital in a one-year period between February 1996 - February 1997 and diagnosed ‘nosocomial infection’ during their follow up were included in this study. The ‘nosocomial infection’ diagnosis used was based on Center for Disease Control (CDC) diagnostics criteria. Clinical findings were recorded besides laboratory and imaging data. Results In one-year period under consideration, a total number of 3420 patients were hospitalized. Nosocomial infection was detected in 9.1% (n=311) of these patients. 28.6% (n=89) of them were acute gastroenteritis, 23.4% (n=73) were urinary tract infection and 25.4% (n=79) were sepsis. The most common etiologic agents were K. pneumoniae (%40.3), Salmonella spp. (%43.0) and E. coli (%13.4). 77.8% of the patients with nosocomial infection were younger than one year old. In patients with urinary tract infection, 28.7% had urethral catheterization. Nosocomial infection was being observed after 16.9±10 days of hospitalization. 12.2% (n=38) of the patients with nosocomial infection have died. Inadequacy of professional staff, insufficient number of nurses per patient and failures in hand washing were thought to be the risk factors in the development of nosocomial infection. Conclusion: Nosocomial infection is an important cause for mortality and morbidity in pediatrics clinics. The most important steps in the efforts to decrease nosocomial infection frequency may be listed as the surveillance, detection of the problems and taking corresponding precautions to take the nosocomial infection under control.

Keywords

• nosocomial infection
• child
• risk factors

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