Nosocomial infections in paediatric and neonatal intensive care units

To describe the epidemiological profile of NI in the PICU and NICU, and its related risk factors.

A prospective surveillance study from May through October 2000 was performed in the PICU and NICU in a tertiary care university hospital in Barcelona.

During the study period, 257 patients were admitted to the PICU and 121 to the NICU. The incidence rate of NI was 26.5 infections per 100 admissions and 1.7 infections per 100 patient-days in the PICU. In the NICU, the incidence rate of NI was 74.3 infections per 100 admissions and 2.7 infections per 100 patient-days. Bacteraemia was the most frequent episode of NI in both units. The most common microorganisms isolated were Gram-positive bacteria (47.2% and 72.7%) in each unit. The factors more frequently associated with NI in the PICU were as follows: patient age under 1 year (RR 5.0; 95% CI 1.6-15.4), class IV of CCS (RR 3.7; 95% CI 1.2-11.1), and mechanical ventilation (RR 2.5; 95% CI 1.0-6.0). In the NICU, the most significant predisposing factors were birth weight less than 1000 g (RR 2.8; 95% CI 1.0-8.0), umbilical arterial catheterization (RR 5.7; 95% CI 1.1-28.5) and parenteral nutrition (RR 2.4; 95% CI 1.2-4.6). The hospital stay was higher in infected patients than in non-infected patients (p<0.001).

This study describes the epidemiological profile of NI in two high-risk paediatric units. These results suggest the need to evaluate the infection control measures with the aim of reducing associated morbidity.