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Hospital-acquired urinary tract infections in the pediatric patient: a prospective study
J A Lohr1, S M Downs, S Dudley
1Division of Community Pediatrics, University of North Carolina School of Medicine, Chapel Hill 27599.
Insights
Hospital-acquired urinary tract infections (HAUTI) are a significant risk for hospitalized children with bladder catheters. While complications are infrequent, these infections warrant attention in pediatric healthcare settings.
Area of Science:
- Pediatric Infectious Diseases
- Hospital Epidemiology
- Urinary Tract Infections
Background:
- Hospital-acquired urinary tract infections (HAUTI) represent a common healthcare-associated infection.
- Urinary catheterization is a known risk factor for HAUTI in pediatric populations.
- Understanding the specific characteristics of HAUTI in children is crucial for effective prevention and management.
Purpose of the Study:
- To prospectively investigate the characteristics of hospital-acquired urinary tract infections (HAUTI) in a pediatric cohort.
- To identify the incidence and risk factors associated with HAUTI in hospitalized children.
- To describe the clinical course and outcomes of pediatric HAUTI.
Main Methods:
- Prospective surveillance of 12,316 hospital admissions over 24 months.
- Identification of children undergoing bladder catheterization (n=525) and those with HAUTI (n=44).
- Analysis of urine culture results, clinical data, and follow-up for at least 6 months post-infection.
Main Results:
- Fifty-one HAUTI cases were identified in 44 pediatric patients (age 1 week to 17 years).
- The majority of HAUTI (76.5%) occurred in catheterized patients, with an incidence of 10.8% among them.
- Most infections (84.3%) were caused by a single organism; complications were infrequent and not life-threatening.
Conclusions:
- Hospitalized children requiring urinary tract catheterization are at considerable risk for developing HAUTI.
- While HAUTI in children can occur, serious complications appear uncommon.
- Further research into targeted prevention strategies for pediatric HAUTI is warranted.
Abstract:
To determine through a prospective study the characteristics of hospital-acquired urinary tract infections (HAUTI) in children, 525 children subjected to bladder catheterization during a hospital admission were identified through surveillance of 12,316 admissions during a 24-month period. Urine culture results were available for 296 (56.4%) of the catheterized patients. In addition 12 noncatheterized children with a documented HAUTI were identified. The clinical courses of all patients with a HAUTI were followed for at least 6 months after their last HAUTI during the study period. Forty-four patients, 1 week to 17 years of age, with 1 or more HAUTI during a hospital unit admission were identified. A total of 51 HAUTI occurred. Thirty-nine (76.5%) of the infections occurred in patients subjected to catheterization. Thirty-two (10.8%) of 296 catheterized patients developed a HAUTI. Forty-three (84.3%) of the 51 infections were single organism infections. One HAUTI was associated with a wound infection with the same organism and one with a concurrent bacteremia with the same organism. Relapses were seen after 4 HAUTI. One reinfection was identified. There were no deaths directly associated with a HAUTI. Hospitalized children subjected to urinary tract catheterization are at significant risk for HAUTI. Complications are infrequent and not life-threatening.