Nosocomial Bacteremia in Children: A 15-Year Experience at a General Hospital in Mexico

Abstract

There were 868 nosocomial bloodstream infections detected in 29,273 subjects (overall rate, 2.94 episodes per 100 discharges). Infection rates were greatest among children admitted to the neonatal intensive care unit and lowest for those admitted to the school-age ward and the infectious diseases ward. There was a significant decrease in rates of nosocomial bacteremia in all of the wards. The organisms isolated most commonly were Klebsiella pneumoniae, Candida species, and coagulase-negative staphylococci. Mortality rates were higher for children with a gram-negative bacterial bloodstream infection (45.2%) and lower for children with a gram-positive bacterial infection (19.2%).Conclusions. Rates of nosocomial bloodstream infection decreased over the past 15 years at our hospital but continue to cause significant mortality. Continuing efforts to decrease the frequency of and mortality due to bloodstream infection are warranted.

314 Healthcare-Associated Infections in Pediatrics

“…This finding was in line with the report from the US [54], while Gram-negative pathogens predominated in the other two studies [53,245]. Neither methicillin resistance in S. aureus isolates nor vancomycin resistance in E. faecium isolates was detected during the study.…”

“…Preoperative stay (OR = 2.7; CI95%, 1.1-6.6) and ASA (OR = 2.4; CI95%, 1.1-5.3) were significant risk factors in one model, but in the other model, none of the covariables was significant by itself. Hospital-wide studies on pediatric nosocomial BSIs are scarce; only three such reports were available, a multi-center report from the US [54], one from an Israeli tertiary care center [53], and one from a Mexican general hospital [245]. We found a BSI rate of 5.7 infections per 1,000 discharges, whereas the overall rates of other studies ranged from 5.3 to 29.4 infections per 1,000 discharges.…”

Reduction of nosocomial infections and mortality attributable to nosocomial infections in pediatric intensive care units in Lithuania

“…Our belief and the knowledge of mortality attributable to NIs comes from historical evidence and from adult ICU, neonatal ICU studies, or from the entire hospital-wide NI surveillance data analyses, published in the last decades (29)(30)(31)(32)(33)(34)(35)(36)(37)(38). However, there are not so many extensive studies from pediatric ICUs or children hospitals supporting this evidence (10,(39)(40)(41)(42). Even more and more often a critical approach regarding the children's mortality due to NI is asserted (10,(41)(42)(43)(44)(45)(46).…”

“…However, there are not so many extensive studies from pediatric ICUs or children hospitals supporting this evidence (10,(39)(40)(41)(42). Even more and more often a critical approach regarding the children's mortality due to NI is asserted (10,(41)(42)(43)(44)(45)(46). Moreover, in a large part of the studies, simply the mortality rate of the group with NI vs. without NI is compared using unadjusted analysis methods, which are not accurate enough to conclude that NI increases the mortality rate by some percentage (10,41,42,44,46).…”

“…Even more and more often a critical approach regarding the children's mortality due to NI is asserted (10,(41)(42)(43)(44)(45)(46). Moreover, in a large part of the studies, simply the mortality rate of the group with NI vs. without NI is compared using unadjusted analysis methods, which are not accurate enough to conclude that NI increases the mortality rate by some percentage (10,41,42,44,46). We used a multivariate regression analysis and time-adjusted survival analysis in order to find a significant association between the NI and the outcome.…”