Document Type : Original Article
Authors
- Amir Saeed 1
- Navid MoradiKashkooli 2
- Anahita Sanaeidashti 1
- Zahra Seratishirazi 1
- Mahvash Alirahimi 2
1 Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran
2 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract
Background: Nosocomial infection (NI) has always been considered a significant problem around the world. Due to the special conditions of the admitted patients, NI is of significant importance in the pediatric intensive care unit (PICU). The present study was an attempt to study the prevalence of NI in PICU and its effects on hospital stay and mortality rate.
Methods: The present research is a retrospective cross-sectional study in which the clinical and laboratory data of 693 patients admitted to the PICU of Namazi Hospital in 2018 was studied. Then, the information was entered into SPSS and analyzed.
Results: Of 693 admitted patients, 101 developed a nosocomial infection in the PICU, accounting for 14.57% of patients. Pneumonia, urinary infection, and septicemia were reported as the most frequent nosocomial infections. The most common pathogen responsible was Staphylococcus aureus and Acinetobacter in pneumonia, Enterococcus in urinary infection, and Stenotrophomonas in septicemia. The present study showed that nosocomial infection was associated with increased hospital stay and mortality rate.
Conclusion: Nosocomial infection is considered an important challenge in the health system; its prevalence in different parts of the world is different, and it was not high in the present study. Nosocomial infection increases mortality and hospital stay and imposes a heavy burden on the health system; therefore, it is vital to decrease its prevalence. These findings can be used to plan for better infection control strategies and decrease nosocomial infection, hospital stay, and mortality rate.
Keywords
- Stein F, Trevino R. Nosocomial infections in the pediatric intensive care unit. Pediatr Clin North Am. 1994 Dec;41(6):1245-57. doi: 10.1016/s0031-3955(16)38871-x. PMID: 7984384.
- Allen U, Ford-Jones EL. Nosocomial infections in the pediatric patient: an update. Am J Infect Control. 1990;18(3):176-93. doi: 10.1016/0196-6553(90)90183-s.
- Reymond J, Aujard Y. Nosocomial infections in pediatric patients: A European multicenter prospective study. European Study Group. Infect Control Hosp Epidemiol. 2000;21(4):260-3. doi: 10.1086/501755. PMID: 10782588.
- Reymond J. Epidemiology of nosocomial infections in pediatrics. Pathol Biol (Paris). 2000;48(10):879-84. PMID: 11204918.
- Spencer RC. Definitions of nosocomial infections. Bailieres Clin Infect Dis. 1996:1;3(2):237-52.
- van Saene HK, Damjanovic V, Murray AE, de la Cal MA. How to classify infections in intensive care units--the carrier state, a criterion whose time has come? J Hosp Infect. 1996;33(1):1-12. doi: 10.1016/s0195-6701(96)90025-0. PMID: 8738198.
- Sievert DM, Ricks P, Edwards JR, Schneider A, Patel J, Srinivasan A, et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009-2010. Infect Control Hosp Epidemiol. 2013;34(1):1-14. doi: 10.1086/668770. PMID: 23221186.
- Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med. 2006;34(6):1589-96. doi: 10.1097/01.CCM.0000217961.75225.E9. PMID: 16625125.
- Daneman N, Sarwar S, Fowler RA, Cuthbertson BH; SuDDICU Canadian Study Group. Effect of selective decontamination on antimicrobial resistance in intensive care units: a systematic review and meta-analysis. Lancet Infect Dis. 2013;13(4):328-41. doi: 10.1016/S1473-3099(12)70322-5. PMID: 23352693.
- Doyle JS, Buising KL, Thursky KA, Worth LJ, Richards MJ. Epidemiology of infections acquired in intensive care units. Semin Respir Crit Care Med. 2011;32(2):115-38. doi: 10.1055/s-0031-1275525. PMID: 21506049.
- Becerra MR, Tantaleán JA, Suárez VJ, Alvarado MC, Candela JL, Urcia FC. Epidemiologic surveillance of nosocomial infections in a Pediatric Intensive Care Unit of a developing country. BMC Pediatr. 2010;10(1):66. doi: 1186/1471-2431-10-66.
- Morillo-García Á, Aldana-Espinal JM, Olry de Labry-Lima A, Valencia-Martín R, López-Márquez R, Loscertales-Abril M, et al. Hospital costs associated with nosocomial infections in a pediatric intensive care unit. Gac Sanit. 2015;29(4):282-7. doi: 10.1016/j.gaceta.2015.02.008.
- Urrea M, Pons M, Serra M, Latorre C, Palomeque A. Prospective incidence study of nosocomial infections in a pediatric intensive care unit. Pediatr Infect Dis J. 2003;22(6):490-4. doi: 10.1097/01.inf.0000069758.00079.d3. PMID: 12799503.
- Masoumi Asl H, Nateghian A. Epidemiology of nosocomial infections in a pediatric intensive care unit (PICU). Iran J Clin Infect Dis. 2009;4(2):83-6.
- Porto JP, Mantese OC, Arantes A, Freitas C, Gontijo Filho PP, Ribas RM. Nosocomial infections in a pediatric intensive care unit of a developing country: NHSN surveillance. Rev Soc Bras Med Trop. 2012;45(4):475-9. doi: 10.1590/s0037-86822012005000003. PMID: 22767099.
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