Nosocomial Infections in Pediatric Patients A European, Multicenter Prospective Study

• Josette Raymond

• Yannick Aujard

抄録

<jats:sec id="S0195941700054795_abs1"> To determine the site and bacterial epidemiology of nosocomial infections (NIs) in children. <jats:sec id="S0195941700054795_abs2"> 6-month prospective study with periodic chart review during hospitalization using a uniform prospective questionnaire in each unit, analyzed at a coordinating center. <jats:sec id="S0195941700054795_abs3"> 20 units in eight European countries: 5 pediatric intensive care units (PICUs), 7 neonatal units, 2 hematology-oncology units, 8 general pediatric units. <jats:sec id="S0195941700054795_abs4"> All children hospitalized during the study period with an NI according to Centers for Disease Control and Prevention criteria. <jats:sec id="S0195941700054795_abs5"> 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. <jats:sec id="S0195941700054795_abs6"> 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.

収録刊行物

• Infection Control & Hospital Epidemiology

  Infection Control & Hospital Epidemiology 21 (4), 260-263, 2000-04

  Cambridge University Press (CUP)

キーワード

• Infectious Diseases
• Microbiology (medical)
• Epidemiology

詳細情報

• CRID: 1360574095056809344
• NII論文ID: 30019634724
• DOI: 10.1086/501755
• ISSN: 15596834
• ISSN: 0899823X
• Web Site: https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0195941700054795
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