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Prospective incidence study of nosocomial infections in a pediatric intensive care unit
Mireya Urrea1, Marti Pons, Marisa Serra
1Quality Service-Infection Control Program, Hospital Saint Joan de Déu, Barcelona, Spain.
Insights
Nosocomial infections in pediatric intensive care units (PICUs) prolong hospital stays. Surveillance identified key infection types and pathogens, guiding prevention strategies to reduce patient morbidity and mortality.
Area of Science:
- Pediatric Intensive Care Unit (PICU) Epidemiology
- Infection Control and Prevention
- Nosocomial Infections Surveillance
Background:
- Nosocomial infections significantly increase morbidity, mortality, and hospital stay duration in pediatric intensive care units (PICUs).
- Understanding the epidemiologic profile of these infections is crucial for effective management.
Purpose of the Study:
- To describe the epidemiologic profile of nosocomial infections in a university hospital's PICU.
- To identify risk factors, common pathogens, and infection rates associated with invasive devices.
Main Methods:
- A prospective surveillance study was conducted over six months in a PICU.
- Standardized Centers for Disease Control and Prevention criteria were used for diagnosis.
- Data on patient demographics, invasive devices, and infection types were collected.
Main Results:
- The overall incidence of nosocomial infections was 1.5 per 100 patient-days.
- Cardiac surgery patients exhibited the highest infection rate (2.3 per 100 patient-days).
- Bacteremia, respiratory infections, and urinary tract infections were most common, often linked to invasive devices. Coagulase-negative staphylococci and Pseudomonas aeruginosa were predominant pathogens.
Conclusions:
- Surveillance effectively highlights the impact of nosocomial infections on hospital stay.
- Findings can inform targeted prevention and control measures to reduce pediatric patient morbidity and mortality in PICUs.
Background:
Nosocomial infections are important causes of substantial morbidity, mortality and prolonged hospital stay in pediatric intensive care units (PICU).
Methods:
A prospective surveillance study was performed in the PICU at a university hospital in Barcelona during the 6 months from May through October 2000 to describe the epidemiologic profile of nosocomial infections. Centers for Disease Control and Prevention criteria were used as standard definitions for nosocomial infections. Data including extrinsic risk factors (invasive devices) associated with nosocomial infections were recorded and device-associated infections were calculated for the specific site.
Results:
During the study period 257 patients were admitted; 15.1% (39) patients had a total of 58 nosocomial infections. The incidence of nosocomial infection was 1.5 per 100 patient-days. Patients with cardiac surgery had the highest nosocomial infection rate, 2.3 per 100 patient-days. Bacteremia (51.7%), respiratory infection (19.0%) and urinary tract infection (17.2%) were the most frequent nosocomial infections observed, and these were associated with use of invasive device. Coagulase-negative staphylococci (39%) and Pseudomonas aeruginosa (24%) were the most common organisms isolated. Nosocomial infection rates per 1000 device days were 23.9 for respiratory infection, 12.4 for bacteremia and 10.7 for urinary tract infection. The durations of hospitalization for patients with and without infection were 22.5 and 9 days, respectively (P < 0.001).
Conclusions:
Performance of surveillance highlights the importance of nosocomial infections and their influence in the hospital stay and can guide selection of prevention and control measures to reduce morbidity and mortality in a PICU.
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