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. 2001 Oct;6(8):571-9.
doi: 10.1093/pch/6.8.571.

Essentials of paediatric infection control

D L Moore  1
Affiliations

Essentials of paediatric infection control

D L Moore. Paediatr Child Health. 2001 Oct.

Abstract
in English, French

Young children readily transmit and acquire nosocomial infections. Children are also vulnerable to endogenous infections as a result of the breakdown of their normal defences by disease, invasive procedures or therapy. The increasing acuity of illness in hospitalized children and therapeutic advances have resulted in a patient population that is increasingly at higher risk for nosocomial infections. Antibiotic resistance has emerged as a problem in some paediatric hospitals, usually in intensive care and oncology units. Infection rates are the highest in neonatal and paediatric intensive care units (where bloodstream infections are the most frequent), and are usually associated with intravascular devices. On general paediatric wards, respiratory and gastrointestinal infections predominate, reflecting the occurrence in the community. The surveillance of nosocomial infections identifies priorities for infection control activities and permits evaluation of interventions.The prevention of transmission between patients and to personnel requires that certain measures be taken with all patients, and that additional precautions be taken with some infections, based on the route of transmission. The prevention of transmission from personnel involves ensuring that personnel are appropriately immunized and counselled about working with infections. The prevention of nosocomial infection also involves control of visitors, appropriate management of invasive procedures and devices, sterilization and disinfection of equipment, provision of a clean environment and adequate staffing. Severely immunocompromised children require extra protection, including ventilation systems that reduce the risk of exposure to filamentous fungi. Infection control in paediatrics is an evolving field that must adapt to changes in the paediatric patient population and in health care technology.

Les jeunes enfants transmettent et acquièrent facilement des infections nosocomiales. Les enfants sont également vulnérables aux infections endogènes par suite de l’effondrement de leurs défenses normales causé par la maladie, des interventions envahissantes ou un traitement. L’acuité croissante de la maladie chez les enfants hospitalisés et les progrès thérapeutiques résultent en une population de patients qui présente un risque plus élevé d’infections nosocomiales. L’antibiorésistance devient un problème dans certains hôpitaux pédiatriques, en général aux soins intensifs et dans les unités d’oncologie. Les taux d’infection sont les plus élevés dans les unités de soins intensifs pédiatriques et néonatales (où les infections sanguines sont les plus courantes) et s’associent généralement aux appareils intravasculaires. Dans les services de pédiatrie générale, les infections respiratoires et gastro-intestinales prédominent, ce qui reflète l’occurrence dans la collectivité. La surveillance des infections nosocomiales permet de repérer des priorités relativement aux activités de contrôle des infections ainsi que de procéder à une évaluation des interventions.

La prévention de la transmission entre les patients ou au personnel exige de prendre certaines mesures auprès de tous les patients et de prendre des précautions supplémentaires à l’égard de certaines infections, d’après la voie de transmission. La prévention de la transmission par le personnel exige une immunisation convenable du personnel et des conseils pertinents quant au travail avec des personnes infectées. La prévention des infections nosocomiales exige également un contrôle des visiteurs, une gestion convenable des interventions et des appareils envahissants, la stérilisation et la désinfection du matériel, la prestation d’un milieu propre et un personnel suffisant. Les enfants très immunocompromis ont besoin d’une protection supplémentaire, y compris des systèmes de ventilation qui réduisent le risque d’exposition aux champignons filamenteux. Le contrôle des infections en pédiatrie constitue un domaine en évolution qui doit s’adapter aux changements dans la population de patients pédiatriques et dans la technologie des soins de santé.

Keywords: Infection control; Nosocomial infections; Paediatric hospitals; Paediatric infections.

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