[Quality control of nosocomial infection in PICU]

Nosocomial infection represents a problem of public health given his high morbidity and mortality, and the cost that it causes to the sanitary system.

To analyze the nosocomial infection related to the principal invasive techniques realized in the paediatric intensive care unit of our hospital.

We prospectively analyzed the epidemiological information (days of hospitalization, days of placement of devices, intravascular and closed drainage system, and mechanical ventilation) and the incidence of nosocomial infections (bacteriemias, pneumonias, urinary tract infections) in the patients admitted during the years 2000-2004.

There was analyzed a total of 302 patients finding an accumulated incidence of nosocomial infection of 9.76 %. The microorganisms isolated with major frequency were the gramnegative stain (46.60 %), followed by Candida sp. (33.30 %) and grampositive cocci (20.01 %). The predominant location of infection was the bacteriemia, with an incidence of 4.09 % (2.99 % of primary bacteraemia Vs 1.10 % of catheter related infection). The mean rate of incidence of bacteriemias associated to intravasculares devices (BADV) was 8.92 (NNISS 7.3 ) with mean rate of utilization of the device of 0.65 (> Pc90 of the NNISS). The pneumonia associated with mechanical ventilation (NAVM) presented a mean rate of incidence of 1.80 departing from a mean rate of utilization of 0.27 (< Pc25 of the NNISS). The urinary infection associated with the closed drainage system presented an average rate of effect of 2.63 , with a mean rate of utilization of the closed drainage system of 0.37 (Pc75).

Nosocomial infection represents an important problem in PICU. These data allow us the knowledge of the incidence of nosocomial infection in our PICU and target the strategies for reducing morbidity and mortality.