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. 2010 Sep 10:10:66.
doi: 10.1186/1471-2431-10-66.

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

María R Becerra  1 , José A Tantaleán, Víctor J Suárez, Margarita C Alvarado, Jorge L Candela, Flor C Urcia
Affiliations

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

María R Becerra et al. BMC Pediatr. .

Abstract

Background: Nosocomial 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.

Methods: We 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.

Results: Four 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).

Conclusions: One 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.

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Figures

Figure 1
Figure 1
Time of death. The Kaplan-Meier curve describes (in weeks) the time of mortality.
Figure 2
Figure 2
Pathogens isolated in ICU patients with BSI. Candida spp was the most common microorganism in bloodstream infection.
Figure 3
Figure 3
Pathogens isolated in ICU patients with VAP. Gram negative predominated in VAP. Only one S aureus was isolated.
Figure 4
Figure 4
Cumulative incidence of nosocomial infections in the Pediatric Intensive Care Unit. Graphic shows the cumulative incidence (in days) of nosocomial infections.
See this image and copyright information in PMC

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