Burden of healthcare-associated infections in a paediatric intensive care unit of a developing country: a single centre experience using active surveillance

• Published in: The Journal of hospital infection Vol. 78; no. 4; pp. 323 - 326
• Main Authors: Gupta, A, Kapil, A, Lodha, R, Kabra, S.K, Sood, S, Dhawan, B, Das, B.K, Sreenivas, V
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.08.2011; Elsevier
• Subjects: Acinetobacter; Adolescent; Bacteremia - epidemiology; Bacteremia - microbiology; Bacteremia - mortality; Bacteria - classification; Bacteria - isolation & purification; Bacterial diseases; Bacterial Infections - epidemiology; Bacterial Infections - microbiology; Bacterial Infections - mortality; Bacterial sepsis; Biological and medical sciences; Bloodstream infection; Child; Child, Preschool; Cross Infection - epidemiology; Cross Infection - microbiology; Cross Infection - mortality; Developing Countries; Device-associated infection; Female; General aspects; Healthcare-associated infection; Human bacterial diseases; Human infectious diseases. Experimental studies and models; Humans; Incidence; Infant; Infant, Newborn; Infectious Disease; Infectious diseases; Intensive Care Units, Pediatric; Length of Stay - statistics & numerical data; Male; Medical sciences; Paediatric intensive care unit; Pneumology; Pneumonia; Pneumonia, Bacterial - epidemiology; Pneumonia, Bacterial - microbiology; Pneumonia, Bacterial - mortality; Prospective Studies; Respiratory system : syndromes and miscellaneous diseases; Urinary Tract Infections - epidemiology; Urinary Tract Infections - microbiology; Urinary Tract Infections - mortality; Ventilator-associated pneumonia; Device-associated infection; Pneumonia; Ventilator-associated pneumonia; Healthcare-associated infection; Bloodstream infection; Paediatric intensive care unit; Human; Lung disease; Nosocomial infection; Respiratory disease; Device; Developing countries; Artificial ventilation; Bacteremia; Intensive care unit; Infection; Surveillance; Bacteriosis; Child; Public health
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2011.04.015

Summary Healthcare-associated infections (HAIs) are an important cause of morbidity and mortality among critically ill patients of all age groups. This prospective surveillance study was performed to estimate the burden of HAIs in a paediatric intensive care unit (PICU) of a developing country. During the 12-month study, 187 patients were treated in the PICU for ≥48 h, of whom 36 patients had 44 episodes of HAIs. The crude infection rate and incidence density (ID) of HAI were 19.3/100 patients and 21/1,000 patient-days, respectively. Of the 44 episodes of HAI, 27 (61%) were healthcare-associated pneumonia (HAP), 12 (27%) were bloodstream infections (HA-BSI) and four (9%) were urinary tract infections. Mean length of stay and mortality were significantly higher in patients who developed an HAI [25 vs 7 days ( P < 0.0001) and 50% vs 27.8% ( P < 0.005), respectively]. Acinetobacter spp. were the commonest infecting bacteria in both HAP and HA-BSI. For developing countries, active surveillance is essential to reduce the burden of HAIs in high risk groups.