Evaluation of Device-associated Nosocomial Infections in a Paediatric Intensive Care Unit

The aim of this study was to evaluate the rate of device-associated healthcare-associated infections (DA-HAI) in a paediatric intensive care unit (PICU). In addition, the identities of the responsible micro-organisms and of their antibiotic sensitivities were determined.

Patients who had been treated and followed-up in a PICU for more than 48 hours between January 2008 and December 2013 were included in the study. Device-associated nosocomial infections were defined by the Centers for Disease Control (CDC) criteria.

Nosocomial infections were detected in 244 of the 7376 patients over the six-year period. A diagnosis of DA-HAI was made in 75 (30.7%) of these infections. The rates of device utilization were 26% for mechanical ventilators, 6% for central venous catheters and 0.9% for urethral catheters. The rate of device-associated infections was 30.7%, and their frequency was 1.9/1000 patient-days. The device-associated nosocomial infection rates for mechanic ventilators, central and urethral catheters were 5.6, 1.62 and 3.77 per 1000 patient-days, respectively. Of these infections, Pseudomonas aeruginosa was the most frequent pathogen. Patients who developed hospital infections had longer durations of ICU hospitalizations and more often had to use mechanical ventilators and central and urinary catheters.

The duration of hospitalization and the use of mechanical ventilators and central and urinary catheters were related to the increases in nosocomial infections. Therefore, target-oriented active surveillance should be regularly performed, and the superfluous employment of invasive devices should be avoided.