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Healthcare-associated Infections in Pediatric Patients in Neurotrauma Intensive Care Unit: A Retrospective Analysis
Chandrakant Prasad1, Ashish Bindra1, Parul Singh2
1Department of Neuroanesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Insights
Healthcare-associated infections (HAIs) are common in pediatric traumatic brain injury (TBI) patients, with respiratory infections and Acinetobacter baumannii being prevalent. These infections significantly worsen patient outcomes.
Area of Science:
- Pediatric critical care medicine
- Infectious disease epidemiology
- Neurotrauma research
Background:
- Healthcare-associated infections (HAIs) are a significant concern in pediatric patients with traumatic brain injury (TBI).
- Understanding the incidence, risk factors, and microbiological landscape of HAIs is crucial for improving outcomes in this vulnerable population.
- This study retrospectively analyzed HAIs in pediatric TBI patients to identify key epidemiological and clinical features.
Observation:
- Data from 423 pediatric TBI patients (age ≤12 years) treated between January 2012 and December 2018 were analyzed.
- HAIs were identified in 144 (34%) patients, with respiratory tract infections being the most common (17.26%).
- Acinetobacter baumannii was the predominant pathogen isolated (41%), showing limited sensitivity to colistin (48.4%).
Findings:
- Independent risk factors for HAIs included higher Injury Severity Score (ISS), male gender, and falls from height.
- Severe TBI, elevated ISS, and higher Marshall grade were significantly associated with increased HAI risk.
- HAIs were strongly correlated with poorer patient outcomes, including mortality and prolonged recovery.
Implications:
- Severe TBI in children necessitates vigilant monitoring for HAIs, particularly respiratory infections caused by multidrug-resistant organisms like Acinetobacter baumannii.
- Early identification and management of risk factors for HAIs are essential to mitigate their impact on patient outcomes.
- This research underscores the need for targeted infection control strategies in pediatric neurotrauma intensive care units.
Background:
Healthcare-associated infections (HAIs) can impact the outcome following traumatic brain injury (TBI) in children. We undertook a retrospective observational study to see the incidence, risk factors, and microbiological profile for HAIs in pediatric TBI. We also studied the impact of baseline patient characteristics, HAIs on patient outcome, and antibiotic resistance of different types of bacteria.
Materials And Methods:
Data on pediatric TBI patients of age up to 12 years were collected via a computerized patient record system (CPRS) from January 2012 to December 2018. Descriptive Chi-square test and Wilcoxon signed rank test were used to characterize baseline parameters. General linear regression models were run to find an unadjusted and adjusted odds ratio (OR).
Results:
HAIs were found in 144 (34%) out of 423 patients. The most commonly seen infections were of the respiratory tract in 73 (17.26%) subjects. The most predominant microorganism isolated was Acinetobacter baumannii in 188 (41%) samples. A. baumannii was sensitive to colistin in 91 (48.4%) patients. Male gender (OR 0.630; p-value 0.035), fall from height (OR 0.374; p-value 0.008), and higher injury severity scale (ISS) (OR 1.040; p-value 0.002) were independent risk factors for development of HAIs. Severe TBI, higher ISS and Marshall grade, and HAIs were significantly associated with poor patient outcome.
Conclusion:
Severe TBI poses a significant risk of HAIs. The most common site was the respiratory tract, predominately infected with A. baumannii. HAIs in pediatric TBI patients resulted in poor patient outcome.
How To Cite This Article:
Prasad C, Bindra A, Singh P, Singh GP, Singh PK, Mathur P. Healthcare-associated Infections in Pediatric Patients in Neurotrauma Intensive Care Unit: A Retrospective Analysis. Indian J Crit Care Med 2021;25(11):1308-1313.
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