Nosocomial Infections in the General Pediatric Wards of a Hospital in Turkey

Abstract

SUMMARY:The aims of this study were to determine the prevalence, type, and clinical features of nosocomial infections (NIs), their etiological distribution, and the antibiotic resistance patterns of causative organisms in the general pediatric wards of a hospital in Turkey over a 3-year period. The Hospital Infection Control Committee NI surveillance reports were used as a database. NIs were detected in 171 (2.25z) of the 7,594 hospitalized patients. Some of these patients experienced more than 1 episode, and thus, the total NI episodes were 229. Patients' age varied from 1 to 144 months (mean ± standard deviation, 14.5 ± 23.6 months). The NI rate was 3.02z, and the NI density was 3.17/1,000 patient days. The most frequent NIs were lower respiratory system infections, blood stream infections, and urinary tract infections. Gram-negative organisms were the most frequently isolated agents. Of the 171 patients with NIs, 47 (27.5z) died.Nosocomial infections (NIs) are the major causes of prolonged hospital stays, increased costs, the increased resistance of organisms to antimicrobials, and mortality in hospitalized adults and children. NIs in pediatric and adult patients differ with respect to the sites of infection and the types of pathogens. In addition, NIs differ by country, region, hospital, and type of units, such as wards or intensive care units (1). There exist many reports on epidemiology, risk factors, and preventive measures for adult NIs. However, studies that focus on the pediatric population, particularly in developing countries, are limited. For this reason, we investigated the epidemiological, microbiological, and clinical features of NIs in the general wards of a pediatric hospital that does not have a pediatric intensive care unit (PICU) facility.Immunocompetent patients who were aged from 1 month to 18 years and had been admitted for miscellaneous diseases and developed a NI between January 2005 and January 2008 in a hospital in Turkey were retrospectively evaluated. The patients who had positive bacterial culture results or had negative culture results but clinical features of infection were included. A positive blood culture that was taken at least 72 h after the preceding positive blood culture was assessed as a new NI episode. The Hospital Infection Control Committee (HICC) NI surveillance reports were used as the database. NIs were defined on the basis of the Centers for Disease Control and Prevention (CDC) criteria (2). Crude NI rates were calculated with the following formula: NI rate ＝ (infection number/admitted or discharged patient number) × 100, and NI density was caluculated with the following formula: density ＝ (infection number/patient day) × 1,000 for each year and ward. The ventilator-associated pneumonia (VAP) rate was calculated with the following formula: VAP rate ＝ (VAP number/mechanical ventilator day) × 1,000. The NIs of each patient were classified according to the infection sites. Standard methods were used for microbiologic, biochemical, and radiologic investigations. Antib...

Attitudes Toward Nosocomial Infections Associated Mortality at Intensive Care Units, and Evaluation of the Risk Factors

“…Similar to the present study, most of the studies found VAP as the most frequent NIs (4,7,12,13,20) and other studies reported analogous rates of NIs in Argentina and Latin American countries (5, 7). Although some studies detected that UTI was the most prevalent NIs (11,21), it is considerable that researches distinguished higher prevalence of NIs in university hospitals (20,22). UTI prevalence in the current study was the third most common type of infection similar to large surveillance program reports across Europe (23).…”

“…Along with the significant relationship between NIs and mortality, the maximal risk of NIs belonged to patients with BSI and UTI in the present study. Although it is reported that VAP had the highest rate of mortality (21,22), some authors reported lower mortality rates for BSI and UTI patients (22,26). These various reported observations may be due to different sampling, classification and diagnosis of the associated underlying data, calculation methods, inclusion and exclusion criteria, studied population and race, geographic regions, lifestyle, and dietary habits.…”

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“…An even more dramatic difference was observed among nosocomial infections (NIs) in a general pediatric hospital in Turkey, where Gram-negative pathogens accounted for 79.8% of cultured pathogens among 229 NIs; the most common pathogens identified were Klebsiella spp. (28.7%), P. aeruginosa (19.1%), and E. coli (9.6%) (13).…”

Bacteriological Profile and Antibacterial Sensitivity Patterns of Isolates among Burn Patients in Sulaimani City

“…But study conducted by Mayhall, C.G. in USA [14], and a study done by Balaban, I., et al in Turkey shows that the commonest pathogens were gram-negative bacteria [15].…”