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[Nosocomial urinary tract infections: retrospective study in a pediatric hospital]
F Moulin1, A Quintart, C Sauvestre
1Service des consultations-urgences, hôpital Saint-Vincent-de-Paul, Paris, France.
Insights
Nosocomial urinary tract infections (UTIs) are common in children, particularly in younger patients and those with risk factors like catheterization. Early diagnosis and prevention strategies are crucial to reduce hospital-acquired UTIs.
Area of Science:
- Pediatric Infectious Diseases
- Hospital Epidemiology
- Clinical Microbiology
Context:
- Urinary tract infections (UTIs) represent a significant portion of hospital-acquired infections in adults, but data on pediatric nosocomial UTIs are limited.
- This study addresses the scarcity of information regarding the incidence and characteristics of nosocomial UTIs in a pediatric hospital setting.
Purpose:
- To determine the incidence of nosocomial UTIs in a pediatric hospital.
- To characterize the affected children, identify common pathogens, and analyze associated risk factors.
Summary:
- A retrospective 1-year study analyzed 1.97/1,000 admissions for nosocomial UTIs (6.8% of all UTIs), predominantly on surgery and neurology wards.
- Infections were more frequent in younger children (50% < 2 years). Key pathogens included E. coli, Pseudomonas sp., and Enterococcus sp., with Pseudomonas sp. and Candida sp. being more prevalent in nosocomial cases.
- Common risk factors were bladder catheterization (41.4%), prior antibiotic therapy (62%), and cerebral palsy (6.9%). No cases of bacteremia were observed.
Impact:
- Highlights the need for careful diagnosis and collaboration between microbiologists and pediatricians for nosocomial UTIs.
- These infections increase healthcare costs but rarely lead to severe complications.
- Identifies modifiable risk factors, such as hand hygiene and catheterization practices, for potential reduction strategies.
Abstract:
Urinary tract infections (UTI) are the most frequent nosocomial infection in the adult, yet very few data are available concerning these infections in children. In a retrospective 1-year study in a paediatric hospital, we analysed the incidence of nosocomial UTI and the characteristics of the affected children. The incidence was of 1.97/1,000 admissions which represented 6.8% of all UTI diagnosed by the microbiology laboratory. Most cases were in surgery and neurology wards. The frequency was inversely proportional to the age, with 50% of children being less than 2 years old. Pathogens most frequently isolated were E coli (39%), Pseudomonas sp (12.1%) and Enterococcus sp (12.1%). When compared with the organisms found in all the urine cultures during the same period, two organisms were more frequently found in nosocomial urinary tract infections: Pseudomonas sp and Candida sp. Most patients presented one or more risk factors, mainly:bladder catheterisation (41.4%), prior antibiotic therapy (62%), cerebral palsy (6.9%). No bacteriema was observed. The diagnosis of nosocomial UTI must be interpreted with caution and needs close collaboration between microbiologists and paediatricians. These infections increase the cost of hospitalisation, but only exceptionally do they present with complications. Some risk factors are inherent in hospital conditions, but others can be reduced by improving hand washing or by changing catheterisation practices.