Nosocomial pulmonary infections in children

Nosocomial infections prolong hospitalization and increase morbidity, mortality, and costs. Unfortunately only 50% of hospital-acquired infections are preventable. Factors that increase the risk for infection include use of monitoring devices, performance of invasive diagnostic and therapeutic procedures, prolonged duration of hospitalization, and impairment of host defense. Diagnosing nosocomial pulmonary infections is challenging. Radiographic studies must be combined with other diagnostic techniques to confirm diagnoses. Aggressive pursuit of a definitive diagnosis is important in evaluation of the compromised host. Specific therapy is preferred over empiric therapy. Outcome is related to the infecting agent and the patient's underlying condition. Preventive measures include hand-washing, isolation of infected patients, and careful attention to aseptic technique when inserting and manipulating catheters. In general, antibiotic therapy will not prevent infection but will alter the patient's flora and increase the likelihood of infection by resistant pathogens.