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Risk factors for developing nosocomial infections among pediatric patients
Suzy Santana Cavalcante1, Eduardo Mota, Luciana Rodrigues Silva
1Department of Pediatrics, Federal University of Bahia, Brazil. suzy_sc@terra.com.br
Insights
Nosocomial infections are common in pediatric hospitals, particularly in infants and those with non-surgical conditions. Risk factors include respiratory disease and intensive care unit stays, leading to longer hospitalizations.
Area of Science:
- Pediatric Epidemiology
- Infectious Diseases
- Hospital-Acquired Infections
Background:
- Nosocomial infections (NIs) significantly contribute to morbidity and mortality in pediatric hospital settings.
- Unique risk factors for pediatric hospital-acquired infections differ from those in adults.
Purpose of the Study:
- To describe the epidemiologic characteristics of nosocomial infections in a pediatric hospital.
- To identify intrinsic and extrinsic risk factors associated with NIs in children.
Main Methods:
- Prospective study conducted in a tertiary-level pediatric hospital in Brazil from January to July 2003.
- Utilized Centers for Disease Control's standard definitions for NIs.
- Collected data on patient demographics and identified intrinsic and extrinsic risk factors.
Main Results:
- 15.4% of 808 patients developed 143 episodes of NI, with an incidence of 9.2 per 1,000 patient-days.
- Higher NI rates were observed in children under 1 year and those with nonsurgical clinical diseases.
- Common NIs included gastrointestinal (39.2%) and respiratory infections (29.4%).
- Key risk factors were respiratory disease on admission, associated admission diagnoses, nonsurgical clinical disease, and pediatric intensive care unit (PICU) residence.
- Patients with NIs had significantly longer hospital stays (14.1 days) compared to those without (5.1 days).
Conclusions:
- Nosocomial infections are a frequent complication in pediatric care.
- NIs are not solely linked to invasive procedures but are associated with specific pediatric risk factors.
- Understanding these pediatric-specific factors is crucial for prevention strategies.
Background:
Nosocomial infections (NIs) are important causes of morbidity and mortality in pediatric hospitals. Multiple factors contribute towards exposing children to the risk of infection when hospitalized, and some of them differ from those in adults.
Methods:
This was a prospective study in a tertiary-level teaching pediatric hospital in Salvador, Bahia, Brazil, conducted from January to July, 2003, to describe the epidemiologic characteristics of NIs. Centers for Disease Control's standard definitions were used and the data recorded included intrinsic and extrinsic risk factors.
Results:
We evaluated 808 patients. There were 143 episodes of NI in 124 patients (15.4%). The overall incidence of NI cases was 9.2 per 1,000 patient-days, with higher rates among children aged less than 1 year (P < 0.001) and those with nonsurgical clinical diseases (P < 0.001). Gastrointestinal infections (39.2%) and eye, ear, nose, throat or mouth infections (29.4%) were most common. The factors most closely associated with higher incidence of NI were respiratory disease on admission (incidence density ratio [IDR], 4.0; 95% confidence interval [CI], 2.83-5.72), another disease associated with admission diagnosis (IDR, 3.5; 95% CI, 2.41-5.02), nonsurgical clinical disease (IDR, 5.9; 95% CI, 3.92-8.85) and pediatric intensive care unit residence (IDR, 3.5; 95% CI, 1.91-6.28). The lengths of hospital stay for patients with and without nosocomial infection were, respectively, 14.1 days (SD, 20.5 days) and 5.1 days (SD, 6.6 days) (t = 121.76; P < 0.001).
Conclusions:
Nosocomial infections are a frequent complication in pediatrics. They are not necessarily related to invasive procedures but certainly are related to a group of factors that have particular characteristics in the pediatric age group.
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