Infections in Pediatric Palliative Care Units: Clinical and Microbiological Perspectives from a Single Center

Area of Science:

• Pediatric Infectious Diseases
• Palliative Care Medicine
• Microbiology

Background:

• Infections and multidrug-resistant (MDR) pathogens pose challenges in pediatric palliative care (PPC) units.
• Children in PPC often undergo invasive procedures and prolonged hospitalizations, increasing infection risk.

Purpose of the Study:

• To evaluate clinical characteristics and microbiological profiles of infections in a PPC unit.
• To identify factors associated with MDR infections among pediatric patients in PPC.

Main Methods:

• Retrospective observational study of 66 children (1 month to 18 years) admitted to a PPC unit for infection.
• Data collected included demographics, comorbidities, device use, infection sites, and microbiological results.
• Bacterial identification and antimicrobial susceptibility testing performed using Vitek2 system.

Main Results:

• Lower respiratory tract infection (68.2%) was most common, followed by sepsis (13.6%) and urinary tract infection (12.1%).
• Predominant pathogens were *Pseudomonas aeruginosa* (36.4%) and *Klebsiella pneumoniae* (27.3%).
• MDR organisms accounted for 15.2% of isolates; MDR infections linked to gastrostomy or mechanical ventilation (p=0.033).

Conclusions:

• Gram-negative MDR infections are a significant issue in PPC units.
• Invasive devices and antibiotic exposure increase susceptibility to resistant pathogens.
• Enhanced infection prevention, antimicrobial stewardship, and device-related infection monitoring are crucial for improving care quality.