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Published on: January 17, 2011
Bloodstream Infection in Children Managed at a Tertiary Hospital in Oman
Nadiya Al Saeghi1, Marwah Al Thuhli1, Hajer Al Hamrashi2
1Department of Child Health, Al Nahda Hospital, Muscat, Oman.
Insights
This study found a high rate of hospital-acquired bloodstream infections (BSI) in Omani children, with Enterobacterales being the most common cause. Pseudomonas aeruginosa significantly increased mortality risk, emphasizing the need for improved infection control.
Area of Science:
- Pediatric Infectious Diseases
- Hospital Epidemiology
- Antimicrobial Resistance
Background:
- Bloodstream infections (BSI) pose a significant threat to pediatric populations, particularly in hospital settings.
- Understanding the local epidemiology and outcomes of BSI is crucial for effective management and prevention strategies.
Purpose of the Study:
- To assess the epidemiology and outcomes of bloodstream infections (BSI) in children in Oman.
- To identify common pathogens, risk factors, and mortality associated with BSI in this cohort.
Main Methods:
- A retrospective study analyzed laboratory-confirmed BSI cases in children aged 0-12 years at Sultan Qaboos University Hospital from 2014-2018.
- Data on demographics, clinical information, and laboratory results were extracted from electronic health records.
Main Results:
- 404 significant BSI episodes were identified in 272 children, with 85.6% occurring in children ≤5 years old.
- Healthcare-related infections accounted for 82.4% of cases. Enterobacterales (37.6%) and coagulase-negative staphylococci (15.6%) were the most frequent pathogens.
- Thirty-day crude mortality was 9.2%. Pseudomonas aeruginosa was an independent predictor of 30-day mortality (aOR = 18.46).
Conclusions:
- A high incidence of healthcare-associated BSI was observed in Omani children.
- Findings underscore the necessity for enhanced infection control measures and optimized care for central venous access devices.
Objectives:
This study aimed to assess the local epidemiology and outcome of bloodstream infection (BSI) among Omani children.
Methods:
This retrospective study was conducted at Sultan Qaboos University Hospital, Muscat, Oman, over 5 years (2014-2018) and included laboratory-confirmed BSI among children aged 0-12 years old. Patients' demographic, clinical and laboratory data were extracted from the hospital's electronic records and used to assess BSI rates and outcomes.
Results:
A total of 1,253 positive blood cultures were identified, of which 592 (47.2%) were regarded as contaminants. Overall, 404 (32.2%) significant episodes of BSI were identified in 272 patients; 346 (85.6%) significant episodes were in children aged ≤5 years and 366 (90.6%) had comorbidities. The 5-year incidence of BSI was 13 per 1,000 admissions. Furthermore, 333 (82.4%) episodes were healthcare-related infections. Enterobacterales (n = 152; 37.6%) were the most common organisms identified followed by coagulase-negative staphylococci (n = 63; 15.6%). Approximately 40% of Gram-negative organisms were resistant to third-generation cephalosporins. The crude mortality rate at 30 days was 9.2%. Paediatric intensive care unit admission (crude odds ratio [COR] = 2.24, 95% confidence interval [CI]: 0.98-4.78) and the presence of graft-versus-host disease (COR = 7.99, 95% CI: 1.52-37.76) were associated with increased death within 30 days. The multivariate logistic regression analysis showed that Pseudomonas aeruginosa (adjusted odds ratio = 18.46, 95% CI: 3.96-97.84) was the only independent predictor of increasing 30-day mortality in this cohort.
Conclusion:
A high rate of hospital-related BSI was found in children in Oman, highlighting the need to optimise infection control strategies and the care of central vein access devices.
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