Prevalence of Nosocomial Infections in Swiss Children's Hospitals

Mühlemann, Kathrin; Franzini, Christine; Aebi, Christoph; Berger, Christoph; Nadal, David; Stähelin, Jody; Gnehm, Hanspeter; Posfay-Barbe, Klara; Gervaix, Alain; Sax, Hugo; Heininger, Ulrich; Bonhoeffer, Jan; Eich, Gerhard; Kind, Christian; Petignat, Christiane; Scalfaro, Pietro (2004). Prevalence of Nosocomial Infections in Swiss Children's Hospitals. Infection control and hospital epidemiology, 25(9), pp. 765-771. Cambridge University Press 10.1086/502474

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Objective: To acquire data on pediatric nosocomial infections (NIs), which are associated with substantial morbidity and mortality and for which data are scarce.
Design: Prevalence survey and evaluation of a new comorbidity index.
Setting: Seven Swiss pediatric hospitals.
Patients: Those hospitalized for at least 24 hours in a medical, surgical, intensive care, or intermediate care ward.
Results: Thirty-five NIs were observed among 520 patients (6.7%; range per hospital, 1.4% to 11.8%). Bacteremia was most frequent (2.5 per 100 patients), followed by urinary tract infection (1.3 per 100 patients) and surgical-site infection (1.1 per 100 patients; 3.2 per 100 patients undergoing surgery). The median duration until the onset of infection was 19 days. Independent risk factors for NI were age between 1 and 12 months, a comorbidity score of 2 or greater, and a urinary catheter. Among surgical patients, an American Society of Anesthesiologists (ASA) score of 2 or greater was associated with any type of NI (P = .03). Enterobacteriaceae were the most frequent cause of NI, followed by coagulase-negative staphylococci; viruses were rarely the cause.
Conclusions: This national prevalence survey yielded valuable information about the rate and risk factors of pediatric NI. A new comorbidity score showed promising performance. ASA score may be a predictor of NI. The season in which a prevalence survey is conducted must be considered, as this determines whether seasonal viral infections are observed. Periodic prevalence surveys are a simple and cost-effective method for assessing NI and comparing rates among pediatric hospitals.

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