Epidemiologic surveillance of nosocomial infections in a Pediatric Intensive Care Unit of a developing country

BMC Pediatrics

Research Article

Flor C Urcia¹  Víctor J Suárez²  Margarita C Alvarado³  Jorge L Candela⁴  María R Becerra⁵  José A Tantaleán⁶ 

[1] Biologist, Instituto Nacional de Salud, Lima, Peru;Infectologist, Tropical Infectious Diseases, Instituto Nacional de Salud, and Universidad César Vallejo, Lima, Peru;Nurse, Instituto Nacional de Salud del Niño, Lima, Peru;Pediatric Infectologist, Instituto Nacional de Salud del Niño, and Universidad San Martín de Porres, Lima, Peru;Pediatric Intensivist, Instituto Nacional de Salud del Niño, Lima, Peru;Pediatric Intensivist, Master in Medicine, Instituto Nacional de Salud del Niño and Universidad Nacional Federico Villarreal, Lima, Peru;

关键词: Intensive Care Unit;    Urinary Tract Infection;    Nosocomial Infection;    Pediatric Intensive Care Unit;    Intensive Care Unit Stay;   

DOI  :  10.1186/1471-2431-10-66

 received in 2010-01-06, accepted in 2010-09-10,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundNosocomial Infections (NI) are a frequent and relevant problem. The purpose of this study was to determine the epidemiology of the three most common NI in a Pediatric Intensive Care Unit from a developing country.MethodsWe performed a prospective study in a single Pediatric Intensive Care Unit during 12 months. Children were assessed for 3 NI: bloodstream infections (BSI), ventilator-associated pneumonia (VAP) and urinary tract infections (UTI), according to Center for Disease Control criteria. Use of devices (endotracheal tube [ETT], central venous catheter [CVC] and urinary catheter [UC]) was recorded.ResultsFour hundred fourteen patients were admitted; 81 patients (19.5%) developed 85 NIs. Density of incidence of BSI, VAP and UTI was 18.1, 7.9 and 5.1/1000 days of use of CVC, ETT and UC respectively. BSI was more common in children with CVCs than in those without CVCs (20% vs. 4.7%, p < 0.05). Candida spp. was the commonest microorganism in BSI (41%), followed by Coagulase-negative Staphylococcus (17%). Pseudomonas (52%) was the most common germ for VAP and Candida (71%) for UTI. The presence of NI was associated with increased mortality (38.2% vs. 20.4% in children without NI; p < 0.001) and the median length of ICU stay (23 vs. 6 days in children without NI; p < 0.001). Children with NI had longer average hospital stay previous to diagnosis of this condition (12.3 vs. 6 days; p < 0.001).ConclusionsOne of every 5 children acquires an NI in the PICU. Its presence was associated with increased mortality and length of stay. At the same time a longer stay was associated with an increased risk of developing NI.

【 授权许可】

Unknown   
© Becerra et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.