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Published on: February 9, 2011
Factors associated with multidrug-resistant bacteria in healthcare-associated infections: a pediatric intensive care
Barbara Barduchi Oliveira da Silva1, Moacyr Silva Júnior1, Fernando Gatti de Menezes1
1Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Insights
Immunocompromised children in pediatric intensive care units face a significantly higher risk of multidrug-resistant bacterial infections. These infections are often linked to Gram-positive bacteria, including Staphylococcus.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- Healthcare-associated infections (HAIs) pose a significant threat in pediatric intensive care units (PICUs).
- Multidrug-resistant bacteria (MDRB) are a growing concern in pediatric healthcare settings.
- Identifying risk factors for MDRB infections in vulnerable pediatric populations is crucial for effective prevention and treatment strategies.
Purpose of the Study:
- To determine the prevalence of factors associated with healthcare-associated infections (HAIs) caused by multidrug-resistant bacteria (MDRB) in a PICU.
- To investigate the specific risk factors contributing to MDRB infections in pediatric patients.
Main Methods:
- A retrospective case-control study was conducted in a high-complexity, tertiary care general hospital's PICU in São Paulo, Brazil.
- The study included pediatric patients aged 1 month to 19 years diagnosed with HAIs between January 1, 2007, and December 31, 2018.
- Statistical analyses, including logistic regression, were employed to identify significant associations between patient characteristics and MDRB infections.
Main Results:
- Immunocompromised status was a significant risk factor for MDRB infections, with an estimated nine-fold higher likelihood (OR 8.97; 95% CI 2.69-29.94) compared to non-immunosuppressed patients.
- Logistic regression confirmed that immunosuppressed patients had an 8.5-fold higher chance of MDRB infection (OR 8.48; 95% CI 2.54-28.35; p=0.001).
- The case group showed a higher proportion of Gram-positive bacteria (p=0.007), coagulase-negative Staphylococcus (p<0.001), and Gram-negative bacteria (p=0.041).
Conclusions:
- Immunocompromised status is a key factor associated with healthcare-associated infections caused by multidrug-resistant bacteria in the PICU.
- The study highlights the increased prevalence of Gram-positive microorganisms and coagulase-negative Staphylococcus in infected patients.
- These findings underscore the need for targeted infection control measures for immunocompromised pediatric patients in intensive care settings.
Objective:
To investigate the prevalence of factors related to healthcare-associated infections, caused by multidrug-resistant bacteria, in a pediatric intensive care unit.
Methods:
A retrospective case-control study conducted from January 1, 2007 to December 31, 2018, in São Paulo (SP), Brazil. The study was carried out at the pediatric intensive care unit of a high-complexity, tertiary care general hospital. The study included patients aged 1 month to 19 years, admitted to the pediatric intensive care unit, diagnosed as healthcare-associated infections.
Results:
There was significant evidence of infection by multidrug-resistant bacteria associated with immunosuppressed patients (p<0.001), in whom the likelihood of multidrug-resistant bacteria infection was estimated to be nine-fold higher than among non-immunosuppressed patients (OR 8.97; 95%CI 2.69-29.94). In the analysis of multiple logistic regression model, we observed that immunosuppressed patients had an 8.5-fold higher chance of multidrug-resistant bacteria infection when compared to non-immunosuppressed patients (OR 8.48; 95%CI 2.54-28.35; p=0.001). There is evidence of association between the Case Group and presence of Gram-positive (p=0.007), coagulase-negative Staphylococcus (p<0.001), and Gram-negative (p=0.041) microorganisms.
Conclusion:
The immunocompromised-state variable is a factor related to healthcare-associated infections caused by multidrug-resistant bacteria, and the Case Group presented higher proportions of Gram-positive microorganisms and coagulase-negative Staphylococcus.
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