LOGIN TO YOUR ACCOUNT

Username
Password
Remember Me
Or use your Academic/Social account:

CREATE AN ACCOUNT

Or use your Academic/Social account:

Congratulations!

You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.

Important!

Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message

CREATE AN ACCOUNT

Name:
Username:
Password:
Verify Password:
E-mail:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Sharland, M; Folgori, L; Bernaschi, P; Piga, S; Carletti, M; Pirrone Cunha, F; Lara, PHR; Cafeiro de Castro Peixoto, N; Gomes Alves Guimares, B; da Silva, ARA; Atti, MCD (2016)
Publisher: Cambridge University Press
Languages: English
Types: Article
Subjects:
Objectives.\ud Our aims were (i) to describe trends in the epidemiology of Healthcare-associated Infections (HAIs) in paediatric/neonatal ICUs and (ii) to evaluate risk factors and impact of Multidrug-Resistance (MDR) in children admitted to ICUs.\ud \ud Design.\ud Multicentre, retrospective, cohort study \ud with a nested case-control study conducted between January 2010 and December 2014.\ud \ud Setting. \ud Three tertiary-care paediatric hospitals in Italy and Brazil with a total of 97 ICU beds. \ud \ud Patients.\ud Inclusion criteria were (i) admission to ICU during the study period (ii) age at onset <18 years and (iii) microbiologically-confirmed HAI.\ud \ud Results.\ud 538 HAIs in 454 children were included. 93.3% of patients had comorbidities. Bloodstream infections (BSIs) were the leading pattern (45.4%). The cumulative incidence of HAI was 3.6/100 ICU-admission and the crude 30-day fatality rate was 5.7/1,000-admission. The most frequently\ud isolated pathogens were Enterobacteriaceae, followed by \ud Pseudomonas aeruginosa and Staphylococcus aureus.44% of isolates were MDR. Two multivariate logistic regressions were performed. Factors independently associated with an MDR\ud -HAI were Country, previous antibiotics, transplantation, major surgery, and colonisation by an MDR strain. Factors independently associated with 30-day case-fatality were Country, previous transplantation, fungal infection, BSI, LRTI, and infection caused by MDR strains. \ud \ud Conclusions.\ud Infection control and prevention should be a primary focus to limit the spread of MDR strains and improve the outcome of hospitalised patients. Targeted surveillance programmes \ud collecting neonatal and paediatric HAI/BSI data and outcomes would allow global benchmarking between centres. The next step is to identify simple methods to monitor key HAIs and integrate these into affordable intervention programmes.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Allegranzi B, Bagheri Nejad S, Combescure C, et al. Burden of endemic health-careassociated infection in developing countries: systematic review and meta-analysis. Lancet 2011;377:228-241.
    • 2. Esteban E, Ferrer R, Urrea M, et al. The impact of a quality improvement intervention to reduce nosocomial infections in a PICU. Pediatr Crit Care Med 2013;14:525-532.
    • 3. Martin-Loeches I, Diaz E, Valles J. Risks for multidrug-resistant pathogens in the ICU. Curr Opin Crit Care 2014;20:516-524.
    • 4. Mathot F, Duke T, Daley AJ, Butcher T. Bacteremia and pneumonia in a tertiary PICU: an 11-year study. Pediatr Crit Care Med 2015;16:104-113.
    • 5. IDSA. The 10 x '20 Initiative: pursuing a global commitment to develop 10 new antibacterial drugs by 2020. Clin Infect Dis 2010;50:1081-1083.
    • 6. McGrath EJ, Asmar BI. Nosocomial infections and multidrug-resistant bacterial organisms in the pediatric intensive care unit. Indian J Pediatr 2011;78:176-184.
    • 7. Mitt P, Metsvaht T, Adamson V, et al. Five-year prospective surveillance of nosocomial bloodstream infections in an Estonian paediatric intensive care unit. J Hosp Infect 2014;86:95-99.
    • 8. Burnham JP, Lane MA, Kollef MH. Impact of Sepsis Classification and Multidrug-Resistance Status on Outcome Among Patients Treated With Appropriate Therapy. Crit Care Med 2015;43:1580-1586.
    • 9. Lambert ML, Suetens C, Savey A, et al. Clinical outcomes of health-care-associated infections and antimicrobial resistance in patients admitted to European intensive-care units: a cohort study. Lancet Infect Dis 2011;11:30-38.
    • 10. Lye DC, Earnest A, Ling ML, et al. The impact of multidrug resistance in healthcareassociated and nosocomial Gram-negative bacteraemia on mortality and length of stay: cohort study. Clin Microbiol Infect 2012;18:502-508.
    • 11. Patel SJ, Oliveira AP, Zhou JJ, et al. Risk factors and outcomes of infections caused by extremely drug-resistant gram-negative bacilli in patients hospitalized in intensive care units. Am J Infect Control 2014;42:626-631
    • 12. Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health careassociated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36:309-332
    • 13. Magiorakos AP, Srinivasan A, Carey RB, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012;18:268-281
    • 14. Monsen T, Karlsson C, Wistrom J. Spread of clones of multidrug-resistant, coagulasenegative staphylococci within a university hospital. Infect Control Hosp Epidemiol 2005;26:76-80
    • 15. Banerjee SN, Grohskopf LA, Sinkowitz-Cochran RL, Jarvis WR. Incidence of pediatric and neonatal intensive care unit-acquired infections. Infect Control Hosp Epidemiol 2006;27:561-570
    • 16. Grohskopf LA, Sinkowitz-Cochran RL, Garrett DO, et al. A national point-prevalence survey of pediatric intensive care unit-acquired infections in the United States. J Pediatr 2002;140:432- 438
    • 17. Rutledge-Taylor K, Matlow A, Gravel D, et al. A point prevalence survey of health careassociated infections in Canadian pediatric inpatients. Am J Infect Control 2012;40:491-496
    • 18. Simon A, Bindl L, Kramer MH. Surveillance of nosocomial infections: prospective study in a pediatric intensive care unit. Background, patients and methods. Klin Padiatr 2000;212:2-9
    • 19. Murni IK, Duke T, Kinney S, Daley AJ, Soenarto Y. Reducing hospital-acquired infections and improving the ratenal use of antibiotics in a developing country: an effectiveness study. Arch Dis Child 2015;100:454-459
    • 20. Muhlemann K, Franzini C, Aebi C, et al. Prevalence of nosocomial infections in Swiss children's hospitals. Infect Control Hosp Epidemiol 2004;25:765-771
    • 21. Logan LK, Braykov NP, Weinstein RA, Laxminarayan R; CDC Epicenters Prevention Program. Extended-Spectrum beta-Lactamase-Producing and Third-Generaten Cephalosporin-Resistant Enterobacteriaceae in Children: Trends in the United States, 1999-2011. J Pediatric Infect Dis Soc 2014;3:320-328
    • 22. Lukac PJ, Bonomo RA, Logan LK. Extended-spectrum beta-lactamase-producing Enterobacteriaceae in children: old foe, emerging threat. Clin Infect Dis 2015;60:1389-1397
    • 23. Gupta N, Limbago BM, Patel JB, Kallen AJ. Carbapenem-resistant Enterobacteriaceae: epidemiology and prevention. Clin Infect Dis 2011;53:60-67
    • 24. Chiotos K, Han JH, Tamma PD. Carbapenem-Resistant Enterobacteriaceae Infections in Children. Curr Infect Dis Rep 2016;18:2
    • 25. Fernandez-Reyes M, Vicente D, Gomariz M, et al. High rate of fecal carriage of extendedspectrum-beta-lactamase-producing Escherichia coli in healthy children in Gipuzkoa, northern Spain. Antimicrob Agents Chemother 2014;58:1822-1824
    • 26. Malacarne P, Boccalatte D, Acquarolo A, et al. Epidemiology of nosocomial infection in 125 Italian intensive care units. Minerva Anestesiol 2010;76:13-23
    • 27. Shime N, Kawasaki T, Saito O, et al. Incidence and risk factors for mortality in paediatric severe sepsis: results from the national paediatric intensive care registry in Japan. Intensive Care Med 2012;38:1191-1197
    • 29. Diez Roux AV, Aiello AE. Multilevel analysis of infectious diseases. J Infect Dis 2005;191 Suppl 1:S25-S33
    • 30. O'Grady NP, Alexander M, Burns LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 2011;52:e162-193
    • 31. Zachariah P, Reagan J, Furuya EY, et al. The association of state legal mandates for data submission of central line-associated bloodstream infections in neonatal intensive care units with process and outcome measures. Infect Control Hosp Epidemiol 2014;35:1133-1139
    • 32. Global Antimicrobial Resistance, Prescribing, and Efficacy among Neonates and Children. Available at: http://garpec.org/. Accessed January 24, 2016
    • 33. European Centre for Disease Prevention and Control: Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals. 2011- 2012. Stockholm: ECDC. 2013. Available at: http://ecdc.europa.eu/en/publications/Publications/healthcare-associated-infectionsantimicrobial-use-PPS.pdf. Accessed January 24, 2016
    • 34. International Nosocomial Infection Control Consortium - INICC. Available at: http://www.inicc.org/. Accessed March 3, 2016 0.912 1.00 0.005 0.031 2.93 (1.08-8.00) 0.036 2.78 0.402
  • No related research data.
  • No similar publications.

Share - Bookmark

Cite this article