Evaluation of healthcare associated infections at pediatric critical care units

Abstract

Health-care associated infection (HAI) constitutes a major health care problem resulting in prolonged hospital stay with increased medical costs. The burden is much greater by accompanying risk factors among intensive care admissions. The incidence is reported 30% of all ICU admissions in developed countries; however the estimated rates are clearly higher in developing countries 3. In order to prevent HAIs, the health-care facilities should determine their own risk factors, analyse the microorganisms isolated from the body fluids and provide the necessary precautions accordingly 5. Despite all the efforts and the advances at preventive protocols, the HAI burden still exits. The pediatric intensive care unit (PICU) of Sivas Cumhuriyet University Hospital is a tertiary critical care unit serving to a broad range of population under 18 years with highly advanced technology within a considerably populated territory. The demographic profiles of the admissions account a wide range of childhood sicknesses from trauma to neurological disorders. The aim of this retrospective study was to examine the microorganism profiles isolated from the body fluids (blood, urine, tracheal aspirates, wound cultures, spinal fluid) of all PICU admissions during the past five years. Hence we decided to obtain our local surveillance data, deploy the necessary precautions to decline HAIs and administer the appropriate antimicrobial therapy accordingly. Method: In this retrospective descriptive study, we searched the medical records of all PICU admissions between January 2014 and December 2018. Children with i) PICU admission lasting over 48 hours, ii) culture positiviy at body fluids, iii) presenting clinical signs of infection were enrolled in the study. Patient demographics, initial complaints, admission diagnosis, the underlying chronical conditions, the source of PICU admission (admission from an indoor clinic, emergency service or an outdoor clinic) and previous hospitalizations were all recorded. We recalled HAI subgroups according to the definitions of centers for disease control and prevention (CDC) 6 such as: ventilator-associated pneumonia (VAP), blood stream infection (BSI), central line-associated bloodstream infections (CLABSIs), catheterassociated urinary tract infections (CAUTI) and surgical site infections (SSI). SPSS-23 (Statistical Package for Social Sciences for Windows 23) was used for statics of the study. Descriptive analyses were expressed as percentages, mean±standart deviation (SD), median with minimum and maximum values. Chi square and Fischer exact test were used for comparison of categorical variables. Normal and non-normal distributions of continous variables were assessed by Student"s t-test, Mann Whitney U test and Wilcoxon rank sum test. P-value < 0.05 was considered significant. Results: Investigation of 1566 PICU admissions between the periods January 2014 and December 2018, presented 56 children with 71 culture positivity at body fluids (infection rate:4.5%). The median age was 15 months (2 months-17 years)...

Investigation of Knowledge and Behaviors of Intensive Care Nurses on the Prevention of Nosocomial Infections and Related Factors

“…Nosocomial infections (NIs) are the most important cause of morbidity and mortality worldwide, according to the center for disease control (CDC) (1). NIs are defined as infections that develop 48 -72 hours after hospitalization and within the first 10 days after discharge or 30 days following surgery (2)(3)(4)(5). As a major global health problem, NIs cause functional disorders, prolongation of hospitalization, and significant morbidity and mortality (3,(6)(7)(8).…”