Nosocomial infections in the pediatric intensive care units in Lithuania

Ašembergienė, Jolanta; Gurskis, Vaidotas; Kėvalas, Rimantas; Valintėlienė, Rolanda

doi:10.3390/medicina45010005

Cited by 30 publications

(38 citation statements)

References 32 publications

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“…3,4,6,[16][17][18]20,22,23 Similar to other developing countries VAP was most common HCAI in our study also. NHSN data for 2010 revealed a pooled mean of 1.2 VAP cases per 1000 ventilator-days.…”

Section: Site-specific/device-associated Infectionssupporting

confidence: 64%

“…(13.6-19.5%). 6,9,[16][17][18] The high incidence rates of HCAI in our PICU as in other developing countries could be multi factorial. Our hospital drains the area with poor standards of living.…”

Section: Discussionmentioning

confidence: 99%

“…14 However, different studies from developing world reported CLA-BSI rate from 7.7 -18.1 per 1000 CVC days. 3,6,[16][17][18]20 …”

Section: Site-specific/device-associated Infectionsmentioning

confidence: 99%

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Clinico-microbiological profile of health-care associated infections in a paediatric intensive care unit of tertiary care hospital

Udawat

Gupta

Manchanda

et al. 2017

Int J Contemp Pediatr

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Background: The study was undertaken to determine the total burden of health-care associated infections, microbiological profile and their impact on length of stay and mortality in a PICU of a tertiary care Hospital by prospective surveillance.Methods: All children ≥ one month and ≤ twelve years of age admitted in PICU for more than 48 hours from December 2009 to November 2010 were followed according to CDC/NHSN surveillance definitions of HCAI. Incidence rates, incidence densities and device utilization ratio were measured for different HCAI. Length of stay and mortality of HCAI were compared with non-HCAI patients. Antibiotic susceptibility pattern of isolated micro-organism was analyzed. Results: Out of total 618 patients admitted in PICU during study period 324 fulfilled study criteria. In those 324 patients 58 patients developed 68 episodes of HCAI. The CIR and IDs’of HCAI were17.9/100 patients and 22.14/1,000 patient-days, respectively. Of the 68 episodes of HCAI, there were 36 VAP, 17 BSI, 8 UTI, 2 pneumonia, 2 LRI-LUNG and 1each of SSI-MED, SST-Skin and GI-IAB. The most common microorganism isolated was Acinetobacter spp. followed by Pseudomonas spp. HCAI increased the average length of PICU stay (20 days versus 5 days, P<0.01) and Hospital stay (28 days versus 12 days, P<0.01). Overall mortality was significantly higher in patients who developed HCAI than non-HCAI (50.9% versus 21.3%, P<0.01).Conclusions: HCAI rates were higher than developed countries. VAP was the most common HCAI followed by BSI. HCAI increased the length of stay and mortality (P<0.01). Organisms isolated in HCAI were more resistant than non-HCAI isolates.

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Section: Site-specific/device-associated Infectionssupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

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Clinico-microbiological profile of health-care associated infections in a paediatric intensive care unit of tertiary care hospital

Udawat

Gupta

Manchanda

et al. 2017

Int J Contemp Pediatr

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“…It has been reported that the incidence of NIs was significantly higher in PICUs than in general wards in Western countries (3)(4)(5). In developing countries, NI rates of PICUs were reported as much higher (6)(7)(8). The distribution of infections by sites may vary with respect to various factors, such as age, properties of hospitals, the prevalence of invasive procedures, risk factors, and associated diseases of patients (3)(4)(5)8).…”

mentioning

confidence: 99%

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

Balaban¹,

Tanır²,

Timur³

et al. 2012

Jpn J Infect Dis

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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...

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“…One of the most important life-threatening medical problems of ICUs globally is NI (6) . Patients undergoing cardiovascular surgery had the highest hospital-acquired infection rate of 23 per 1000 patients.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Properties, Pathogens, and Mortality-Related Risk Factors of Nosocomial Infections in Pediatric Cardiovascular Surgery Intensive Care Unit

Karaağaç¹

2017

Kosuyolu Heart Journal

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Introduction:The aim of this study was to evaluate the properties, pathogens, mortality-related risk factors, and mortality rates of nosocomial infections (NIs) in the pediatric cardiovascular surgery intensive care unit. Patients and Methods:The files of 838 children, aged 0-16 years, who underwent cardiovascular surgery between January, 2014 and January, 2016 in Kartal Koşuyolu Research Hospital were evaluated in this retrospective study. NI was diagnosed according to the Center for Disease Control criteria. The correlations between several risk factors and NI were statistically analyzed.Results: Fifty-four children out of 838 (6.4%) had NI. 29 of them (53.9%) had respiratory tract infections, 14 (24.8%) had urinary tract infections, 8 (15.7%) had bacteremia and 3 (5.6%) had wound site infections. The isolated pathogens were Klebsiella pneumoniae (20.4%), Pseudomonas aeruginosa (18.6%), Candida albicans (18.6%), Stenotrophomonas maltophilia (13.8%), Acinetobacter baumannii (10.5%), coagulasenegative staphylococci (9.1%), methicillin-resistant Staphylococcus aureus (MRSA, 3.6%), Serratia marcescens (1.8%), Citrobacter freundii (1.8%), and Providencia rettgeri (1.8%). The mortality rate due to NI was 13.7% (11/80). There was a statistically significant relationship between NIs and age and duration of mechanic ventilation (p< 0.05), but not between NIs and gender, accompanying abnormalities, and nasogastric feeding (p> 0.05). Conclusion:Gram-negative bacteria were the most common pathogens of NI, which caused mortality. Assessing the responsible pathogens and determining the risk factors will help us to develop effective infection control measures for reducing the morbidity and mortality rates.

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Nosocomial infections in the pediatric intensive care units in Lithuania

Cited by 30 publications

References 32 publications

Clinico-microbiological profile of health-care associated infections in a paediatric intensive care unit of tertiary care hospital

Clinico-microbiological profile of health-care associated infections in a paediatric intensive care unit of tertiary care hospital

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

Evaluation of Properties, Pathogens, and Mortality-Related Risk Factors of Nosocomial Infections in Pediatric Cardiovascular Surgery Intensive Care Unit

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