Medical care related laboratory-confirmed bloodstream infections in paediatrics

Area of Science:

• Pediatric Infectious Diseases
• Clinical Microbiology
• Healthcare Epidemiology

Background:

• Healthcare-associated infections, including laboratory-confirmed bloodstream infections (LCBIs), pose a significant threat in pediatric settings.
• Understanding the incidence, epidemiology, and microbiology of LCBIs is crucial for effective prevention and treatment strategies.

Purpose of the Study:

• To prospectively investigate the incidence, epidemiology, microbiology, risk factors, and outcomes of medical care-related LCBIs in a pediatric teaching hospital.
• To compare findings with existing literature data on LCBIs in children.

Main Methods:

• A twelve-month prospective study involving children with clinical signs of sepsis and positive microbiological tests (blood culture, PCR, intravascular device tip culture).
• Data collection included patient demographics, infection type (healthcare-associated, community-acquired), causative microorganisms, and outcomes.

Main Results:

• 140 episodes of sepsis in 131 children were documented; 65% were healthcare-associated, 26.4% healthcare outpatient-associated, and 8.6% community-acquired.
• The incidence of healthcare-associated LCBIs was 13.6/1,000 hospitalized patients, with an overall mortality of 3.9%.
• Coagulase-negative staphylococci, Staphylococcus aureus, Escherichia coli, and Candida spp. were the most common pathogens. Methicillin-resistant S. aureus and extended-spectrum beta-lactamase-producing Gram negatives were identified.

Conclusions:

• Incidence and epidemiology of LCBIs in this cohort align with existing literature.
• LCBIs caused by antibiotic-resistant microorganisms were less frequent, and the overall mortality rate was lower than previously reported.
• Newborns and pediatric oncology patients represented the majority of LCBIs, highlighting vulnerable populations.