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Published on: February 9, 2011
Hospital-associated infections in children: a prospective post-discharge follow-up survey in three different
S Kinnula1, M Buettcher, T Tapiainen
1Department of Pediatrics, University of Oulu, Finland.
Insights
Most viral hospital-associated infections (HAIs) in children occur after discharge. Single rooms and separate units effectively prevent viral HAIs, particularly respiratory infections.
Area of Science:
- Pediatric Infectious Diseases
- Hospital Epidemiology
- Infection Prevention and Control
Background:
- Viral hospital-associated infections (HAIs) show significant frequency variation (1-24%) in pediatric settings.
- The reasons behind these HAI rate disparities across pediatric wards and hospitals are not well understood.
Purpose of the Study:
- To determine the incidence of viral HAIs in pediatric patients.
- To identify risk factors associated with viral HAIs in three distinct pediatric hospitals.
Main Methods:
- Prospective data collection over two years in Finnish and Swiss pediatric wards.
- Infections were tracked during hospitalization and for one week post-discharge.
- Multivariate logistic regression analyzed ward-specific HAI risk factors.
Main Results:
- Overall HAI frequency was 12.2%, with 2.4% occurring during hospitalization and 9.8% post-discharge.
- HAI rates ranged from 5.8% to 17.1% between wards.
- Risk factors included shared rooms, prolonged hospitalization, and younger age.
Conclusions:
- The majority of pediatric viral HAIs manifest after patient discharge.
- Single-room accommodation is effective in preventing HAIs, especially respiratory viruses.
- Dedicated units for contagious diseases demonstrate a beneficial impact on HAI prevention.
Background:
Reported viral hospital-associated infection (HAI) frequencies have ranged from 1% to 24% between paediatric wards and hospitals. Reasons for this variation remain unclear.
Aim:
To evaluate the rate of viral HAIs and risk factors in three different paediatric hospitals.
Methods:
Data were collected prospectively for two years in one infectious disease ward and three general paediatric wards in Finland and Switzerland. Infections were recorded during the hospitalization and one week after discharge. Ward-specific risk factors for HAIs within each ward were searched by using multivariate logistic regression analysis.
Findings:
Altogether 5119 patients were hospitalized. Total HAI frequency was 12.2%, with 2.4% of the patients developing HAI in hospital, most often gastroenteritis, and 9.8% [95% confidence interval (CI): 8.9-10.8%] within 72 h of discharge. HAI rates varied from 5.8% to 17.1% between the wards, the highest rate being in a general paediatric ward where shared rooms were common and active cohorting according to viral aetiology was not done. Shared room (OR: 5.45; 95% CI: 2.44-12.2 in a general ward treating infants), longer hospitalization (OR: 1.42 per day; 95% CI: 1.20-1.67 in an infectious disease ward) and young age (OR: 0.71 per year; 95% CI: 0.51-0.98 in general paediatric ward for children aged >1 year) increased risk of HAI in hospital.
Conclusion:
Most viral HAIs in paediatric wards become evident after discharge. Single room bedding appears to be effective in preventing HAIs, especially the spread of respiratory viruses. It also appears that caring for patients with contagious diseases in a separate unit is advantageous.
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