Device-associated infections in a paediatric intensive care unit in Pakistan

Area of Science:

• Infection Control and Epidemiology
• Pediatric Critical Care Medicine

Background:

• Device-associated infections (DAIs) are a significant concern in pediatric intensive care units (PICUs).
• Effective infection control strategies are crucial for patient safety in critical care settings.

Purpose of the Study:

• To evaluate the impact of implementing active infection control and surveillance on DAI rates in a PICU.
• To identify specific types of DAIs and their incidence within the study period.

Main Methods:

• A retrospective analysis of patients admitted to a PICU between 2012 and 2015.
• Monitoring and recording of device-associated infections, including central-line-associated bloodstream infections, ventilator-associated pneumonia, and catheter-related urinary tract infections.
• Calculation of incidence rates per 1000 patient-days and per device-days.

Main Results:

• A total of 1378 patients and 4632 patient-days were analyzed, with 29 DAI episodes.
• The overall DAI incidence rate was 2.1%, with an incidence density of 6.26 per 1000 patient-days.
• Specific rates included 7/1000 central-line-days for CLABSIs, 1.17/1000 ventilator-days for VAP, and 0.24/1000 urinary-catheter-days for CRUTIs.
• A relatively high rate of central-line-associated bloodstream infections (CLABSIs) was observed despite overall low DAI rates.

Conclusions:

• Implementation of active infection control and surveillance was associated with low overall DAI rates in the PICU.
• Central-line-associated bloodstream infections represent a persistent challenge requiring targeted interventions.
• Continued vigilance and focused strategies are necessary to further reduce device-associated infections in pediatric critical care.