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[Nosocomial bacteremias in pediatrics]
N Gayvallet-Montredon1, C Sauvestre, M Bergeret
1Service de microbiologie, hôpital Saint-Vincent-de-Paul, Assistance publique-hôpitaux de Paris, 74-82, avenue Denfert-Rochereau, 75674 Paris, France.
Summary
Hospital-acquired bloodstream infections in children are often caused by Gram-positive cocci. Key risk factors include central venous catheter use, prolonged hospital stay, and parenteral nutrition.
Area of Science:
- Pediatric Infectious Diseases
- Hospital Epidemiology
- Microbiology
Background:
- Hospital-acquired bloodstream infections (HA-BSI) pose a significant threat to pediatric patients.
- Identifying causative pathogens and risk factors is crucial for effective prevention and treatment strategies.
Purpose of the Study:
- To determine the microorganisms responsible for HA-BSI in pediatric units.
- To evaluate the risk factors associated with HA-BSI in hospitalized children.
Main Methods:
- A case-control study was conducted over 30 months (January 1997 - June 1999).
- Data on positive blood cultures and patient characteristics were collected.
- Statistical analysis, including odds ratios and confidence intervals, was used to identify risk factors.
Main Results:
- The incidence of HA-BSI was 0.11 per 100 admissions, with 5.4% of positive blood cultures attributed to nosocomial infections.
- Gram-positive cocci, particularly Staphylococcus aureus, were the most common pathogens.
- Significant risk factors identified included prolonged length of stay, central venous catheter use, and parenteral nutrition.
Conclusions:
- Central venous catheter use, extended hospitalization, and parenteral nutrition are major risk factors for HA-BSI in children.
- Intravenous lipids were particularly highlighted as a risk factor.
- These findings underscore the importance of infection control measures targeting these factors.