[Risk factors for nosocomial bacterial infection in children: a case-control study]

With the objective to identify independent risk factors associated with the development of nosocomial bacteremia, we have performed a prospective, exploratory, case-control study. All non-neutropenic children with nosocomial bacteremia admitted during a seven-month period were eligible. All children non-neutropenic without nosocomial bacteremia were eligible as controls. The incidence of bacteremia in the study population was 11.3/1000 admissions. Ninety one cases and ninety nine controls were analyzed. In 46% of patients clinical foci were detected. The catheter-related infection was the most frequently founded. Staphylococcus spp coagulase negative, Staphylococcus aureus and Klebsiella pneumoniae were the microorganisms more frequently isolated. Multivariate analysis identified five risk factors independently associated with nosocomial bacteremia: admission outside of Intensive Care Units (ICU) (OR: 8.14, 2.60-25.5), previous antibiotic treatment (OR: 5.02, 2.18-11.5), invasive procedures (OR: 5.35, 1.70-16.8), without surgery (OR: 2.99, 1.37-6.52) and the presence of central venous lines (OR: 5.35, 2.13-12.4). Our data give strong support for the value of testing strict guidelines for limiting vascular catheter and antibiotic use, and limiting the invasive procedures.