Estudio multicéntrico nacional sobre la infección nosocomial en la UCIP

Jordan, Iolanda; Arriourtúa, A. Bustinza; Concha-Torre, Andrés; Antón, J. Gil; Vicente, Juan Carlos de; González, C. Téllez

doi:10.1016/j.anpedi.2010.09.010

Cited by 18 publications

(5 citation statements)

References 31 publications

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“…Awasthi et al revealed that VAP developed in 36.2% of children requiring mechanical ventilation in India [ 24 ]. Another recent national multicenter study on nosocomial infections in Spain, reported very low incidence of VAP (1.3%) among children undergoing mechanical ventilation in PICU [ 25 ]. Our estimated incidence is in line with another study conducted on Iranian children, reporting the incidence of VAP to be 27% [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Incidence of Ventilator-Associated Pneumonia in Critically Ill Children Undergoing Mechanical Ventilation in Pediatric Intensive Care Unit

et al. 2017

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Background: Among hospital-acquired infections (HAIs) in children, ventilator-associated pneumonia (VAP) is the most common after blood stream infection (BSI). VAP can prolong length of ventilation and hospitalization, increase mortality rate, and directly change a patient’s outcome in Pediatric Intensive Care Units (PICU). Objectives: The research on VAP in children is limited, especially in Iran; therefore, the identification of VAP incidence and mortality rate will be important for both clinical and epidemiological implications. Materials and Methods: Mechanically ventilated pediatric patients were assessed for development of VAP during hospital course on the basis of clinical, laboratory and imaging criteria. We matched VAP group with control group for assessment of VAP related mortality in the critically ill ventilated children. Results: VAP developed in 22.9% of critically ill children undergoing mechanical ventilation. Early VAP and late VAP were found in 19.3% and 8.4% of VAP cases, respectively. Among the known VAP risk factors that were investigated, immunodeficiency was significantly greater in the VAP group (p = 0.014). No significant differences were found between the two groups regarding use of corticosteroids, antibiotics, PH (potential of hydrogen) modifying agents (such as ranitidine or pantoprazole), presence of nasogastric tube and total or partial parenteral nutrition administration. A substantial number of patients in the VAP group had more than four risk factors for development of VAP, compared to those without VAP (p = 0.087). Mortality rate was not statistically different between the VAP and control groups (p = 0.477). Conclusion: VAP is still one of the major causes of mortality in PICUs. It is found that altered immune status is a significant risk factor for acquiring VAP. Also, occurrence of VAP was high in the first week after admission in PICU.

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Section: Discussionmentioning

confidence: 99%

Incidence of Ventilator-Associated Pneumonia in Critically Ill Children Undergoing Mechanical Ventilation in Pediatric Intensive Care Unit

et al. 2017

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“…In subsequent studies, to eliminate bias caused by the differences of overall medical level between different units, units with greater proportions of critical cases, higher proportions of use of mechanical ventilation, and more enrolled cases were selected as cooperative units (16). However, a comparison of the rates of abandonment, mortality rates, and total medical costs of AHRF of different hospitals and different areas, the results showed that there were no statistically significant differences between them in the developed and less developed areas.…”

Section: Discussionmentioning

confidence: 99%

Multicenter study on the prognosis associated with respiratory support for children with acute hypoxic respiratory failure

Guo

Lin

Zhen

et al. 2016

Experimental and Therapeutic Medicine

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The objective of the present study was to explore the factors influencing the outcomes related to respiratory support of children with acute hypoxic respiratory failure (AHRF) in 30 hospitals. This was a non-controlled prospective and collaborative multicenter clinical study conducted from June, 2010 to May, 2011 (each hospital for 12 consecutive months). Children aged from 29 days to 6 years and who met the diagnostic standards of AHRF were enrolled as subjects for the study. After patients were enrolled, general parameters including disease diagnosis, treatment and prognosis were recorded. Then we analyzed the differences in prognosis and respiratory therapy of patients with AHRF. During the study period, 13,906 cases of AHRF were admitted among the 30 hospitals, accounting for 75.3% of the total number of patients with AHRF. The proportion in different hospitals ranged from 16 to 98%. A total of 492 children with hypoxic respiratory failure were admitted among the 30 hospitals. The prevalence rate was 3.54%, and the incidence of AHRF in each hospital was 4.54%. Tidal volume and respiratory support treatment were compared with the results from a 2006 study, and the differences were statistically significant in positive end-expiratory pressure (5 vs. 4, P=0.018), fraction of inspire O2 (0.5 vs. 0.4, P<0.001), pressure of artery O2 (70 vs. 60 mmHg, P<0.001) and peak inspiratory pressure (20 vs. 24 cm H2Ο, P<0.001). In conclusion, academic background and the level of regional economic development are factors which influence the prognosis of children with AHRF. On the basis of unapparent differences between academic background and the level of regional economic development, there is a substantial difference in the prognosis from different forms of respiratory support management for AHRF. Therefore, it is essential to develop respiratory support and the level of critical management of pediatric intensive care units.

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“…There are several risk factors for developing an infection acquired in the PICU, such as requiring surgery, extracorporeal membrane oxygenation (ECMO), renal replacement therapy or parenteral nutrition, presenting neutropenia, or carrying devices (central line, urinary catheter or endotracheal tube, among others) [ 2 , 4 , 5 ]. In fact, in pediatric population, the most common HAIs are those associated with medical devices: central-line-associated blood stream infections (CLABSIs), ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infections (CAUTIs) [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs

et al. 2022

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Healthcare-associated infections related to device use (DA-HAIs) are a serious public health problem since they increase mortality, length of hospital stay and healthcare costs. We performed a multicenter, prospective study analyzing critically ill pediatric patients admitted to 26 Spanish pediatric intensive care units (PICUs) over a 3-month period each year from 2014 to 2019. To make comparisons and evaluate the influence of HAI Zero Bundles (care bundles that intend to reduce the DA-HAI rates to zero) on PICU HAI rates, the analysis was divided into two periods: 2014–2016 and 2017–2019 (once most of the units had incorporated all the Zero Bundles). A total of 11,260 pediatric patients were included. There were 390 episodes of HAIs in 317 patients and the overall rate of HAIs was 6.3 per 1000 patient days. The DA-HAI distribution was: 2.46/1000 CVC days for central-line-associated bloodstream infections (CLABSIs), 5.75/1000 MV days for ventilator-associated pneumonia (VAP) and 3.6/1000 UC days for catheter-associated urinary tract infections (CAUTIs). Comparing the two periods, the HAI rate decreased (p = 0.061) as well as HAI episodes (p = 0.011). The results demonstrate that exposure to devices constitutes an extrinsic risk factor for acquiring HAIs. The multivariate analysis highlights previous bacterial colonization by multidrug-resistant (MDR) bacteria as the most important extrinsic risk factor for HAIs (OR 20.4; 95%CI 14.3–29.1). In conclusion, HAI Zero Bundles have been shown to decrease HAI rates, and the focus should be on the prompt removal of devices, especially in children with important intrinsic risk factors.

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Estudio multicéntrico nacional sobre la infección nosocomial en la UCIP

Cited by 18 publications

References 31 publications

Incidence of Ventilator-Associated Pneumonia in Critically Ill Children Undergoing Mechanical Ventilation in Pediatric Intensive Care Unit

Incidence of Ventilator-Associated Pneumonia in Critically Ill Children Undergoing Mechanical Ventilation in Pediatric Intensive Care Unit

Multicenter study on the prognosis associated with respiratory support for children with acute hypoxic respiratory failure

Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs

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