Nosocomial infections and antibiotic resistance in a tertiary university hospital pediatric intensive care unit

Nosocomial infections and antibiotic resistance in a tertiary university hospital pediatric intensive care unit

Aim: Nosocomial infections (NI) cause failed treatments and long hospitalization periods in pediatric intensive care units (PICUs),leading to severe rates of mortality, morbidity and high hospitalization costs. This study intends to offer a retrospective review of thetypes of NI, active pathogens as well as antibiotic resistance profiles of inpatients followed up and treated in the PICU of a tertiaryuniversity hospital.Material and Methods: In this study, in-patients who were treated in an intensive care unit between January 2014 and June 2018were evaluated retrospectively. Patients’ data were obtained from the Infection Control Committee database. Based on this data, therate of NIs, the distribution of NIs by the systems, the invasive device-related infection rate, the infectious agents and the antibioticresistance of these agents at the PICU were determined within the specified time-frame.Results: In this study, 536 patients receiving treatment at a PICU between January 2014 and June 2018 were examined. A NI episodedeveloped in 69 (12.6%) of these patients. The NI rate was 12.87/100 applications. The mean hospitalization length of stay of thepatients was 17.65 days. Bloodstream infections due to the use of central venous catheters were the most common form of NI. Inthis study, of all the NI agents, Gram (-) microorganisms were isolated the most. The most commonly isolated microorganism wasAcinetobacter baumannii (A. baumannii). The rate of carbapenem resistant A. baumannii was 85%.Conclusion: In PICUs, surveillance measures for infection control and rational use of antibiotics are important in terms of preventinghigh mortality and morbidity rates and hospitalization costs due to resistant microorganisms.

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  • 1. World Health Organization, Department of Communicable Disease, Surveillance and Response. Prevention of Hospital acquired Infections. Geneva, Switzerland: World Health Organization; 2002. Publication WHO/CDS/CSR/ EPH/2002.12.
  • 2. Khan HA, Baig FK, Mehboob R. Nosocomial infections: epidemiology, prevention, control and surveillance. Asian Pac J Trop Biomed 2017;7:478–82.
  • 3. Sydnor ER, Perl TM. Hospital epidemiology and infection controlin acute-care settings. Clin Microbiol Rev 2011;24:141–73.
  • 4. Jarvis WR. Epidemiology of nosocomial infections in pediatric patients. Pediatr Infect Dis J 1987;6:344–51.
  • 5. Muhlemann K, Franzini C, Aebi C, et al. Prevalence of nosocomial infections in Swiss children’s hospitals. Infect Control Hosp Epidemiol 2004;25:765–71.
  • 6. Rutledge-Taylor K, Matlow A, Gravel D, et al. A point prevalence survey of health care-associated infections in Canadian pediatric inpatients. Am J Infect Control 2012;40:491–96.
  • 7. Büke Ç. Sürveyansın Önemi. Klimik Dergisi 2007;20:139- 41.
  • 8. Clinical Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Twentythird Informational Supplement. M100-S23, CLSI Vol 34, No:1, 2014. Wayne, PA
  • 9. Tablan OC, Anderson LJ, Arden NH, et al. Guideline for prevention of nosocomial pneumonia. Infect Control Hosp Epidemiol 1994;15:588-627.
  • 10. Abulhasan YB, Rachel SP, Châtillon-Angle M-O, et al. Healthcare-associated infections in the neurological intensive careunit: results of a 6-year surveillance study at a major tertiary care center. Am J Infect Control 2018;46:656– 62.
  • 11. Becerra MR, Tantaleán JA, Suárez VJ, et al. Epidemiologic surveillance of nosocomial infections in a pediatric intensive care unit of a developing country. BMC Pediatr 2010;10:66.
  • 12. Bion J, Richardson A, Hibbert P, et al. Matching Michigan Collaboration & Writing Committee. BMatching Michigan: a 2-year stepped interventional programme tominimise central venous catheter-blood streaminfections in intensive care units in England. BMJ Qual Saf 2013;22:110–23.
  • 13. Raymond J, Aujard Y. The European Study Group. Nosocomial infections in pediatric patients: A European multicenter study. Infect Control Hosp Epidemiol 2000;21:260-3.
  • 14. Kepenekli E, Soysal A, Yalindag-Ozturk N, et al. Turkish PICU-HCAI Study Group A national point-prevalence survey of pediatric intensive care unit-acquired, healthcareassociated infections in Turkey. Jpn J Infect Dis 2015;13:1- 17.
  • 15. Grohskopf LA, Sinkowitz-Cochran RL, Garrett DO, et al. Pediatric Prevention Network A national point-prevalence survey of pediatric intensive care unit-acquired infections in the United States. J Pediatr 2002;140:432-8.
  • 16. Richards MJ, Edwards JR, Culver DH, et al. Nosocomial infections in pediatric intensive care units in the United States. Pediatrics 1999;103:39.
  • 17. Lee MK, Chiu CS, Chow VC, et al. Prevalence of hospital infection and antibiotic use at a university medical center in Hong Kong. J Hosp Infect 2007;65:341-7.
  • 18. Durando P, Icardi G, Ansaldi F, et al. Surveillance of hospitalacquired infections in Liguria, Italy: results from a regional prevalence study in adult and paediatric acutecare hospitals. J Hosp Infect 2009;71:81-7.
  • 19. Gravel D, Matlow A, Ofner-Agostini M, et al. A point prevalence survey of health care-associated infections in pediatric populations in major Canadian acute care hospitals. Am J Infect Control 2007;35:157-62.
  • 20. Araujo da Silva AR, Henriques CT, Werneck LS. Health care associated infections by multidrug resistant organisms in pediatric intensive care: Analysis of four years. Int J Infect Control 2014;v10:i3.
  • 21. MacVane S.H., D. Pharm. Antimicrobial resistance in the intensive care unit: a focus on gram-negative bacterial infections. J Intensive Care Med 2017;32:25–37.
  • 22. Mwanri L, E AlSaleh. Multi-drug resistantorganisms and patients risk factors in the intensive care unit of King Fahad Hofuf hospital, Saudi Arabia. Int. J. Health Psychol. Res. 2014;2:8–25.
  • 23. WHO report of prioritization of pathogens. Fact sheet. Available at who.int/entity/mediacentre/news/ releases/2017/ drug-resistant-tb/en (accessed December 2017).
  • 24. Sopirala MM, Mangino JE, Gebreyes WA, et al. Synergy testing by Etest, microdilution checkerboard, and time-kill methods for pan-drug-resistant Acinetobacter baumannii. Antimicrob Agents Chemother 2010;54:4678–83.
  • 25. Jung JY, Park MS, Kim SE, et al. Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the intensive care unit. BMC Infect Dis 2010;10:228.
  • 26. Chuang YC, Cheng CY, Sheng WH, et al. Effectiveness of tigecycline-based versus colistin-based therapy for treatment of pneumonia caused by multidrugresistant Acinetobacter baumannii in a critical setting: A matched cohort analysis. BMC Infect Dis 2014; 14:102.
  • 27. Adams-Haduch JM, Onuoha EO, et al. Molecular epidemiology of carbapenem- nonsusceptible Acinetobacter baumannii in the United States. J Clin Microbiol 2011;49:3849–54.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
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