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Hospital-associated infections during and after care in a paediatric infectious disease ward
S E Kinnula1, M Renko, T Tapiainen
1Department of Paediatrics, University of Oulu, Oulu, Finland.
Insights
Most pediatric hospital-associated infections (HAIs) occur after discharge, primarily as diarrhea. Older children had lower HAI risk, while shared rooms increased risk for respiratory patients, highlighting post-discharge surveillance needs.
Area of Science:
- Pediatric Infectious Diseases
- Hospital Epidemiology
- Infection Prevention and Control
Background:
- Hospital-associated infections (HAIs) are a significant concern in pediatric populations.
- Viruses are a common cause of HAIs in children.
- Understanding the timing and location of HAIs is crucial for effective control.
Purpose of the Study:
- To evaluate the incidence of viral HAIs during hospitalization and post-discharge in a pediatric infectious disease ward.
- To identify risk factors associated with HAIs in this setting.
- To assess the importance of post-discharge surveillance for pediatric HAIs.
Main Methods:
- Prospective data collection over two years in a pediatric infection ward.
- Inclusion of follow-up questionnaires for parents to report new infections post-discharge.
- Definition of HAIs as infections occurring >72 hours after admission or <72 hours after discharge.
Main Results:
- 1.1% of patients developed HAIs during hospitalization, exclusively diarrhea.
- 7.3% of children experienced new symptoms within 72 hours of discharge, most commonly diarrhea (49%).
- Older age was protective against HAIs (OR: 0.92), while shared rooms increased HAI risk in respiratory patients (OR: 2.3).
Conclusions:
- A significant proportion of pediatric HAIs occur after hospital discharge, emphasizing the need for post-discharge monitoring.
- Environmental factors like room sharing play a role in HAI transmission.
- Effective infection control strategies, including hand hygiene and potentially isolation, are vital in pediatric wards.
Abstract:
Viruses are important causes of paediatric hospital-associated infections (HAIs). We evaluated the frequency of viral HAIs during hospitalisation and after discharge in a paediatric infection ward. Data were collected prospectively for two years with follow-up questionnaires in which parents reported symptoms of new infections. Infections occurring >72 h after admission to hospital or <72 h after discharge were regarded as hospital-associated. The mean age of patients was 3.0 years and the mean hospitalisation time 3.0 days. Twenty-one out of the 1927 patients [1.1%, 95% confidence interval (CI): 0.7-1.7] developed an HAI during hospitalisation, in every case diarrhoea. A total of 1175 (61%) questionnaires were returned. In all, 86 children (7.3%, 95% CI: 5.9-9.0) had new symptoms within 72 h of discharge, most often diarrhoea (49%). Older age protected against HAI [odds ratio (OR, per year in age): 0.92; 95% CI: 0.85-0.99; P=0.02]. Among the patients hospitalised for respiratory infections, a shared room increased the risk of HAI (OR: 2.3; 95% CI: 1.1-4.8; P=0.03). Eight percent of the patients in our ward, where alcohol hand gel is actively used and single rooms are common, developed an HAI. Eighty percent of the HAIs appeared at home, which emphasises the importance of post-discharge follow-up.
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