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Nosocomial bloodstream infections in a pediatric intensive care unit: 3-year survey.

Abstract：

BACKGROUND:Bloodstream infections (BSI) represent a major cause of hospital-acquired infections in pediatric intensive care unit (PICU) patients. This study was designed to determine the prevalence, risk factors and outcomes of these infections in one local facility. MATERIAL/METHODS:All patients admitted to one PICU between January 1, 2000 - December 31, 2002 and subsequently developed a nosocomial bloodstream infection (NBSI) were consecutively recruited. The study was a retrospective study. Data retrieved from medical records included demographic information, extrinsic (invasive devices) and intrinsic risk factors, specific pathogens, therapeutic interventions and outcome. RESULTS:There were 95 episodes of NBSIs in 59 patients (63/1711 PICU admissions, yielding an incidence of 56/1000). The crude mortality rate (CMR) in children with NBSIs was 52%, compared with 6% for all other children admitted to the PICU. A higher CMR was associated with hemato-oncology illness, prolonged length of hospitalization (>1 month) mechanical ventilation, dialysis and severity of illness. Most of the patients (95%) had central intravascular devices, and 73% of the episodes were catheter-related infections. The most frequent pathogens were coagulase-negative staphylococci (24%), Klebsiella pneumonia (16%), Candida spp. (15%), Pseudomonas aeruginosa (7%) and Staphylococcus aureus (6%). Thirty-three percent of the Staphylococcus aureus were methicillin resistant (MRSA) and 30% of the Klebsiella pneumonia were extended - spectrum beta-lactamase - producing (ESBL) strains. CONCLUSIONS:The overall incidence of NBSIs was 56 episodes per 1000 admissions. The major risk factors were hemato-oncology illness, prolonged length of hospitalization, mechanical ventilation, dialysis and severity of illness. Children with NBSI had a poor outcome when compared with children without NBSI.

journal_name

Med Sci Monit

journal_title

Medical science monitor : international medical journal of experimental and clinical research

authors

Grisaru-Soen G,Sweed Y,Lerner-Geva L,Hirsh-Yechezkel G,Boyko V,Vardi A,Keller N,Barzilay Z,Paret G

subject

Has Abstract

pub_date

2007-06-01 00:00:00

pages

CR251-7

issue

eissn

1234-1010

issn

1643-3750

pii

484116

journal_volume

pub_type

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Nosocomial bloodstream infections in a pediatric intensive care unit: 3-year survey.