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Nosocomial Infections in Pediatric Patients A European, Multicenter Prospective Study

Published online by Cambridge University Press:  02 January 2015

Josette Raymond ,
Yannick Aujard  and
European Study Group
Josette Raymond*
Affiliation:
Service Microbiologie, Hôpital Robert Debré, Paris, France
Yannick Aujard
Affiliation:
Hôpital Saint Vincent de Paul, and the Service Néonatologiegie, Hôpital Robert Debré, Paris, France
*
Service Microbiologie, Hôpital Saint Vincent de Paul, 82 avenue Denfert-Rochereau, 75014 Paris, France
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Abstract

Objectives.

To determine the site and bacterial epidemiology of nosocomial infections (NIs) in children.

Design:

6-month prospective study with periodic chart review during hospitalization using a uniform prospective questionnaire in each unit, analyzed at a coordinating center.

Setting:

20 units in eight European countries: 5 pediatric intensive care units (PICUs), 7 neonatal units, 2 hematology-oncology units, 8 general pediatric units.

Participants:

All children hospitalized during the study period with an NI according to Centers for Disease Control and Prevention criteria.

Results:

The overall incidence of NI was 2.5%, ranging from 1% in general pediatric units to 23.6% in PICUs. Bacteria were responsible for 68% (gram-negative bacilli, 37%; gram-positive cocci, 31%), Candida for 9%, and viruses for 22% of cases. The proportion of lower respiratory tract infections was 13% in general pediatric units and 53% in PICUs. Bloodstream infections were most frequent in neonatal units (71% of NIs) and were associated with a central venous catheter in 66% of cases. Coagulase-negative Staphylococcus (CNS) was the main pathogen. Eleven percent of NI were urinary tract infections. Gastrointestinal infections were most commonly viral and accounted for 76% of NIs in general pediatric units.

The prevalence of antimicrobial resistance depended on the type of unit. The highest rates were observed in PICUs: 26.3% of Staphylococcus aureus and 89% of CNS were methicillin-resistant, and 37.5% of Klebsiella pneumoniae had an extended-spectrum β-lactamase. Mortality due to NI was 10% in PICUs and 17% in neonatal units.

Conclusions:

We found large differences in NI frequency and microbial epidemiology in this European study. Viruses were the main pathogens in general pediatrics units. Catheter-related sepsis and CNS were frequent in newborns. A high frequency of multiresistant bacteria was observed in some units. Clinical monitoring of NIs and bacterial resistance profiles are required in all pediatric units.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 21 , Issue 4 , April 2000 , pp. 260 - 263
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2000

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