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.
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.
Authors: V D Rosenthal; B Ramachandran; W Villamil-Gómez; A Armas-Ruiz; J A Navoa-Ng; L Matta-Cortés; M Pawar; A Nevzat-Yalcin; M Rodríguez-Ferrer; R D Yıldızdaş; A Menco; R Campuzano; V D Villanueva; L F Rendon-Campo; A Gupta; O Turhan; N Barahona-Guzmán; O O Horoz; P Arrieta; J M Brito; M C V Tolentino; Y Astudillo; N Saini; N Gunay; G Sarmiento-Villa; E Gumus; A Lagares-Guzmán; O Dursun Journal: Infection Date: 2012-02-28 Impact factor: 3.553
Authors: Youssef A Al-Tonbary; Othman E Soliman; Mohammed M Sarhan; Moustafa A Hegazi; Rasha A El-Ashry; Ashraf A El-Sharkawy; Osama S Salama; Raida Yahya Journal: World J Pediatr Date: 2010-06-12 Impact factor: 2.764
Authors: Derek S Wheeler; Howard E Jeffries; Jerry J Zimmerman; Hector R Wong; Joseph A Carcillo Journal: World J Pediatr Congenit Heart Surg Date: 2011-07-01