Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-28T08:02:57.028Z Has data issue: false hasContentIssue false
  • English
  • Français

Nosocomial Bacteremia in Children: A 15-Year Experience at a General Hospital in Mexico

Published online by Cambridge University Press:  02 January 2015

Luis Fernando Pérez-González ,
Juana María Ruiz-González  and
Daniel E. Noyola
Luis Fernando Pérez-González*
Affiliation:
Pediatrics Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México Unidad de Vigilancia Epidemiológica, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México Hospital Central “Dr. Ignacio Morones Prieto,”, and the Departments of Pediatrics, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
Juana María Ruiz-González
Affiliation:
Unidad de Vigilancia Epidemiológica, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
Daniel E. Noyola
Affiliation:
Pediatrics Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México Microbiology, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
*
Unidad de Vigilancia Epidemiológica, Hospital Central “Dr. Ignacio Morones Prieto,”Avenida Venustiano Carranza 2395, San Luis Potosí, S.L.P., México78210 ([email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective.

To describe the incidence and etiology of nosocomial bloodstream infections in children at a general hospital.

Design.

Review of nosocomial bloodstream infections detected in children during 1991-2005. Data were prospectively gathered through active surveillance. Annual rates of infection were compared.

Setting.

A public general hospital in San Luis Potosi, Mexico.

Patients.

Children younger than 15 years of age admitted to pediatric wards and subjected to prospective surveillance for nosocomial infection.

Interventions.

Measures instituted to decrease the incidence of hospital-acquired infection during the 15-year study period included establishing active surveillance for hospital-acquired infection, reinforcing compliance with handwashing recommendations, decreasing the degree of crowding on wards, establishing guidelines for the management of intravenous catheters and solutions, preparing parenteral nutrition and intravenous solutions under a laminar air-flow hood, and increasing nursing personnel.

Results.

There were 868 nosocomial bloodstream infections detected in 29,273 subjects (overall rate, 2.94 episodes per 100 discharges). Infection rates were greatest among children admitted to the neonatal intensive care unit and lowest for those admitted to the school-age ward and the infectious diseases ward. There was a significant decrease in rates of nosocomial bacteremia in all of the wards. The organisms isolated most commonly were Klebsiella pneumoniae, Candida species, and coagulase-negative staphylococci. Mortality rates were higher for children with a gram-negative bacterial bloodstream infection (45.2%) and lower for children with a gram-positive bacterial infection (19.2%).

Conclusions.

Rates of nosocomial bloodstream infection decreased over the past 15 years at our hospital but continue to cause significant mortality. Continuing efforts to decrease the frequency of and mortality due to bloodstream infection are warranted.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 4 , April 2007 , pp. 418 - 422
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Richards, MJ, Edwards, JR, Culver, DH, Gaynes, RP. Nosocomial infections in pediatric intensive care units in the United States. National Nosocomial Infections Surveillance System. Pediatrics 1999;103:e39.Google Scholar
2.Diekema, DJ, Beekmann, SE, Chapin, KC, Morel, KA, Munson, E, Doern, GV. Epidemiology and outcome of nosocomial and community-onset bloodstream infection. J Clin Microbiol 2003;41:3655–3660.Google Scholar
3.Secretaría de Salud. Norma Oficial Mexicana de Emergencia NOM-EM-002-SSA2-2003, Para la Vigilancia Epidemiológica, Prevención y Control de las Infecciones Nosocomiales. Mexico, DF; 2003.Google Scholar
4.O'Grady, NP, Alexander, M, Dellinger, EP, et al.Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention. MMWR Recomtn Rep 2002;51(RR-10):1–29.Google ScholarPubMed
5.Avila-Figueroa, C, Cashat-Cruz, M, Aranda-Patron, E, et al.Prevalence of nosocomial infections in children; survey of 21 hospitals in Mexico [in Spanish]. Salud Publica Mex 1999;41:S18–S25.Google ScholarPubMed
6.Muñoz, JM, Macías, AE, Guerrero, FJ, Hernández, I, Medina, H, Vargas, E. Control of pediatric nosocomial bacteremia by a program based on culturing of parenteral solutions in use [in Spanish]. Salud Publica Mex 1999;41:S32–S37.Google Scholar
7.Avila-Figueroa, R, Ramírez-Galván, L, Alpuche-Aranda, C, Arredondo-García, JL, Santos-Preciado, JI. Infecciones nosocomiales en un hospital pediátrico. Salud Publica Mex 1986;28:616–622.Google Scholar
8.Martinez-Aguilar, G, Anaya-Arriaga, MC, Avila-Figueroa, C. Incidence of nosocomial bacteremia and pneumonia in pediatric unit [in Spanish]. Salud Publica Mex 2001;43:515–523.Google Scholar
9.Padilla Barron, G, Guiscafre Gallardo, H, Martinez Garcia, MC, Vargas de la Rosa, R, Palacios Treviño, J, Muñoz Hernandez, O. Epidemiología de las infecciones nosocomiales en un hospital pediátrico. Salud Publica Mex 1986;28:599–610.Google Scholar
10.Diaz-Ramos, RD, Solórzano-Santos, F, Padilla-Barron, G, Miranda-Novales, MG, Gonzalez-Robledo, R, Trejo y Pérez, JA. Nosocomial infections: experience at a third-level pediatric hospital [in Spanish]. Salud Publica Mex 1999;41:S12–S17.Google Scholar
11.Zamora-Castorena, S, Murguía-de-Sierra, MT. Cinco años de experiencia con sepsis neonatal en un centro pediátrico. Rev Invest Clin 1998;50:463–470.Google Scholar
12.Ponce-de-León- Rosales, S, Macías, AE. Global perspectives of infection control. In: Wenzel, RP, ed. Prevention and Control of Nosocomial Infections. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2003:14–32.Google Scholar
13.Wisplinhoff, H, Bischoff, T, Tallent, SM, Seifert, H, Wenzel, RP, Edmond, MB. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 2004;39:309–317.CrossRefGoogle Scholar
14.Yogaraj, JS, Elward, AM, Fraser, VJ. Rate, risk factors, and outcomes of nosocomial primary bloodstream infection in pediatric intensive care unit patients. Pediatrics 2002;110:481–485.Google Scholar
15.Isaacs, D. A ten year, multicentre study of coagulase negative staphylococcal infections in Australasian neonatal units. Australasian Study Group for Neonatal Infections. Arch Dis Child Petal Neonatal Ed 2003;88:F89–F93.Google Scholar
16.Gray, J, Gossain, S, Morris, K. Three-year survey of bacteremia and fungemia in a pediatric intensive care unit. Pediatr Infect Dis J 2001;20:416–421.Google Scholar
17.Armenian, SH, Singh, J, Arrieta, AC. Risk factors for mortality resulting from bloodstream infections in a pediatric intensive care unit. Pediatr Infect Dis J 2005;24:309–314.Google Scholar
18.Tseng, YC, Chiu, YC, Wang, JH, et al.Nosocomial bloodstream infection in a neonatal intensive care unit of a medical center: a three-year review. J Microbiol Immunol Infect 2002;35:168–172.Google Scholar
19.Rodriguez-Weber, MA, López-Candiani, C, Arredondo-García, JL, Gutiérrez-Castrellón, P, Sánchez-Arriaga, F. Neonatal sepsis morbidity and mortality in a tertiary care hospital [in Spanish]. Salud Publica Mex 2003;45:90–95.CrossRefGoogle ScholarPubMed
20.Karlowicz, MG, Buescher, ES, Surka, AE. Fulminant late-onset sepsis in a neonatal intensive care unit, 1988-1997, and the impact of avoiding empiric vancomycin therapy. Pediatrics 2000;106:1387–1390.Google Scholar