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Healthcare-Associated Infections at a Children's Cancer Hospital, 1983-2008
Jonathan A McCullers1, Bonnie F Williams2, Song Wu3
1Departments of Infectious Diseases Infection Control and Prevention jon.mccullers@stjude.org.
Journal of the Pediatric Infectious Diseases Society
|May 21, 2013
Summary
Healthcare-associated infections in children with cancer decreased significantly over 26 years. Low absolute neutrophil counts (ANC) are a key risk factor for these infections, highlighting the need for targeted prevention strategies.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Limited data exist on healthcare-associated infections (HAIs) in immunocompromised children.
- Understanding incidence and causes of HAIs is crucial for this vulnerable population.
Purpose of the Study:
- To analyze trends in HAI rates, types, and causative organisms over 26 years.
- To identify risk factors for HAIs in pediatric cancer patients.
Main Methods:
- Prospective data collection from 1983-2008 at a children's cancer hospital.
- Analysis of infection rates per 100 discharges and per 1000 patient-days.
- Evaluation of absolute neutrophil count (ANC) nadir as a risk factor.
Main Results:
- HAI rates significantly decreased from 5.6 to 2.0 per 100 discharges.
- Bloodstream infections were the most common type (32.7%).
- Low ANC (<100/mm³) was strongly associated with increased infection risk (P<.0001).
Conclusions:
- Sustained reductions in HAIs are achievable in pediatric cancer settings.
- Despite increased hospital capacity, infection rates declined.
- An ANC nadir <100/mm³ is a significant risk factor for HAIs in this population.
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