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Takashima M, Hyun A, Xu G, Lions A, Gibson V, Cruickshank M, Ullman A. Infection Associated With Invasive Devices in Pediatric Health Care: A Meta-analysis. Hosp Pediatr 2024; 14:e42-e56. [PMID: 38161188 DOI: 10.1542/hpeds.2023-007194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
CONTEXT Indwelling invasive devices inserted into the body for extended are associated with infections. OBJECTIVE This study aimed to estimate infection proportion and rates associated with invasive devices in pediatric healthcare. DATA SOURCES Medline, CINAHL, Embase, Web of Science, Scopus, Cochrane CENTRAL, clinical trial registries, and unpublished study databases were searched. STUDY SELECTION Cohort studies and trials published from January 2011 to June 2022, including (1) indwelling invasive devices, (2) pediatric participants admitted to a hospital, (3) postinsertion infection complications, and (4) published in English, were included. DATA EXTRACTION Meta-analysis of observational studies in epidemiology guidelines for abstracting and assessing data quality and validity were used. MAIN OUTCOMES AND MEASURES Device local, organ, and bloodstream infection (BSIs) pooled proportion and incidence rate (IR) per-1000-device-days per device type were reported. RESULTS A total of 116 studies (61 554 devices and 3 632 364 device-days) were included. The highest number of studies were central venous access devices associated BSI (CVAD-BSI), which had a pooled proportion of 8% (95% confidence interval [CI], 6-11; 50 studies) and IR of 0.96 per-1000-device-days (95% CI, 0.78-1.14). This was followed by ventilator-associated pneumonia in respiratory devices, which was 19% (95% CI, 14-24) and IR of 14.08 per-1000-device-days (95%CI, 10.57-17.58). CONCLUSIONS Although CVAD-BSI and ventilator associated pneumonia are well-documented, there is a scarcity of reporting on tissue and local organ infections. Standard guidelines and compliance initiatives similar to those dedicated to CVADs should be implemented in other devices in the future.
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Affiliation(s)
- Mari Takashima
- The University of Queensland, Queensland, Australia
- Centre for Children's Health Research, Children's Health Queensland Hospital and Health Service, Queensland, Australia
| | - Areum Hyun
- The University of Queensland, Queensland, Australia
| | - Grace Xu
- The University of Queensland, Queensland, Australia
- NHMRC Centre for Research Excellence in Wiser Wound Care, Griffith University, Queensland, Australia
| | | | - Victoria Gibson
- The University of Queensland, Queensland, Australia
- Centre for Children's Health Research, Children's Health Queensland Hospital and Health Service, Queensland, Australia
| | - Marilyn Cruickshank
- Sydney Children's Hospitals Network, New South Wales, Australia
- The University of Technology Sydney, New South Wales, Australia
| | - Amanda Ullman
- The University of Queensland, Queensland, Australia
- Centre for Children's Health Research, Children's Health Queensland Hospital and Health Service, Queensland, Australia
- NHMRC Centre for Research Excellence in Wiser Wound Care, Griffith University, Queensland, Australia
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Kouhi R, Panahi R, Ramezankhani A, Amin Sobhani M, Khodakarim S, Amjadian M. The effect of education based on health belief model on hand hygiene behavior in the staff of Tehran dentistry centers: A quasi-experimental intervention study. Health Sci Rep 2023; 6:e1408. [PMID: 37425231 PMCID: PMC10324357 DOI: 10.1002/hsr2.1408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023] Open
Abstract
Background and Aims Considering the increasing prevalence of dental services in the community and the impossibility of identifying each infected patient, hand sanitation is the most critical factor in controlling infection in these centers. Therefore, this study aimed to determine the effect of educational intervention on the hand health behavior of the staff of Tehran dentistry clinics based on the health belief model (HBM). Methods In this quasi-experimental study in 2017, 128 employees of the health centers were selected through a multistage sampling method and they were placed in two groups of intervention and control (each 64 people). The data was collected using a questionnaire devised by the researcher. The validity and reliability of the questionnaire were determined. The questionnaire consisted of demographics, knowledge, structures of the HBM, and behavior variables. Then, the intervention was administered based on HBM-based education. Data were analyzed by SPSS16 and independent t test, χ 2, and repeated measurement analysis of variance. Results Before the intervention, the two intervention and control groups did not differ significantly in terms of demographic variables, mean scores of knowledge, constructs of HBM, and hand hygiene behavior (p > 0.05), while the intervention group was scored higher significantly compared to the control one after the intervention (p < 0.001). Conclusion According to the findings, the HBM can be used as a framework for designing educational interventions to improve hand hygiene behavior to control infection in health centers.
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Affiliation(s)
- Reza Kouhi
- Department of Health Education, School of HealthShahid Beheshti University of Medical SciencesTehranIran
| | - Rahman Panahi
- Department of Public Health, Qaen School of Medical SciencesBirjand University of Medical SciencesBirjandIran
| | - Ali Ramezankhani
- Department of Public HealthShahid Beheshti University of Medical SciencesTehranIran
| | - Mohsen Amin Sobhani
- Department of Endodontics, School of DentistryAja University of Medical SciencesTehranIran
| | - Soheila Khodakarim
- Department of BiostatisticsShiraz University of Medical SciencesShirazIran
| | - Mohiadin Amjadian
- Department of English LanguageKurdistan University of Medical SciencesSanandajIran
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Topal S, Demir E, Atakul G, Çolak M, Soydan E, Karaarslan ÜU, Yaşar N, Kıymet E, Devrim İ, Ağın H. The effect of tracheotomy on ventilator-associated pneumonia rate in children. Int J Pediatr Otorhinolaryngol 2020; 132:109898. [PMID: 32018162 DOI: 10.1016/j.ijporl.2020.109898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/12/2019] [Accepted: 01/18/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Data on the relationship between tracheotomy and ventilator-associated pneumonia (VAP) in children is very limited. We planned to evaluate the effect of tracheotomy on VAP rates in children. MATERIALS AND METHODS We evaluated patients who underwent tracheotomy during follow-up at the pediatric intensive care unit (PICU) of our hospital. Patients who were diagnosed as VAP at least once and followed by a mechanical ventilation (MV) for at least 30 days before and after tracheotomy were included in our study. The underlying diagnoses of the patients and the number of VAP diagnosis, VAP rates (VAP number x1000/day of MV) before and after tracheotomy were recorded. Logistic regression analysis was used to compare VAP rates before and following a tracheotomy. RESULTS There were a total of 47 patients including 28 (59.6%) girls and 19 (40.4%) boys in our study. The duration of MV before tracheotomy was 74.9 ± 48.9 (31-295) days and after tracheotomy, it was 103.3 ± 102.8 (30-586) days. The number of VAP before tracheotomy was 0.9 ± 1.2 (0-8) and after tracheotomy, it was 0.6 ± 0.6 (0-3). The VAP rate before tracheotomy was 5.9 ± 6.3 (0-26.5) and the VAP rate after tracheotomy was 3.2 ± 3.8 (0-11.4). Ventilator-associated pneumonia rates were lower following tracheotomy (OR:0.91,95%CI:0.826-0.981,p = 0.017). CONCLUSION Tracheotomy decreased the VAP rate in children receiving long-term mechanical ventilatory support.
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Affiliation(s)
- Sevgi Topal
- Health Sciences University, Dr. Behcet Uz Children's Hospital, Pediatric Intensive Care Unit, Turkey.
| | - Emine Demir
- Recep Tayyip Erdogan University Faculty of Medicine, Department of Otorhinolaryngology, Turkey
| | - Gülhan Atakul
- Health Sciences University, Dr. Behcet Uz Children's Hospital, Pediatric Intensive Care Unit, Turkey
| | - Mustafa Çolak
- Health Sciences University, Dr. Behcet Uz Children's Hospital, Pediatric Intensive Care Unit, Turkey
| | - Ekin Soydan
- Health Sciences University, Dr. Behcet Uz Children's Hospital, Pediatric Intensive Care Unit, Turkey
| | - Ünal Utku Karaarslan
- Health Sciences University, Dr. Behcet Uz Children's Hospital, Pediatric Intensive Care Unit, Turkey
| | - Nevbahar Yaşar
- Health Sciences University, Dr. Behcet Uz Children's Hospital, Infection Control Committee, Turkey
| | - Elif Kıymet
- Health Sciences University, Dr. Behcet Uz Children's Hospital, Department of Pediatric Infectious Diseases, Turkey
| | - İlker Devrim
- Health Sciences University, Dr. Behcet Uz Children's Hospital, Department of Pediatric Infectious Diseases, Turkey
| | - Hasan Ağın
- Health Sciences University, Dr. Behcet Uz Children's Hospital, Pediatric Intensive Care Unit, Turkey
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Leone M, Bouadma L, Bouhemad B, Brissaud O, Dauger S, Gibot S, Hraiech S, Jung B, Kipnis E, Launey Y, Luyt C, Margetis D, Michel F, Mokart D, Montravers P, Monsel A, Nseir S, Pugin J, Roquilly A, Velly L, Zahar J, Bruyère R, Chanques G. Pneumonies associées aux soins de réanimation* RFE commune SFAR–SRLF. MEDECINE INTENSIVE REANIMATION 2019. [DOI: 10.3166/rea-2019-0106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ventilator Associated Pneumonia in Children: Current Status and Future Prospects. Indian J Pediatr 2018; 85:830-831. [PMID: 30196351 DOI: 10.1007/s12098-018-2783-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 08/28/2018] [Indexed: 10/28/2022]
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Vijay G, Mandal A, Sankar J, Kapil A, Lodha R, Kabra SK. Ventilator Associated Pneumonia in Pediatric Intensive Care Unit: Incidence, Risk Factors and Etiological Agents. Indian J Pediatr 2018; 85:861-866. [PMID: 29616405 PMCID: PMC7101689 DOI: 10.1007/s12098-018-2662-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 03/09/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To study the incidence, etiology and risk factors associated with ventilator associated pneumonia (VAP) in children. METHODS This prospective cohort study was conducted on patients admitted to the Pediatric Intensive Care Unit (PICU) of a tertiary care institute of North India, from June 2012 through March 2014, who received mechanical ventilation for more than 24 h. All enrolled children were assessed daily for development of ventilator associated pneumonia (VAP) using the case definition given by Centers for Disease Control and Prevention (CDC). Chest radiograph and microbiologic samplings were performed in children suspected to have VAP. Risk factors associated with VAP were calculated by doing bivariate and multivariate analysis. RESULTS A total of 128 patients were screened and 86 were enrolled (median age 30 mo 95% CI 4.0-84.0; 72% boys). The most common admitting diagnosis was sepsis (16%) followed by acyanotic congenital heart disease with pneumonia (14%) and the most common indication for ventilation was respiratory failure (45.3%). The incidence of VAP according to CDC criteria was 38.4%, while the incidence of microbiologically confirmed VAP was 24.4%. The incidence of ventilator associated tracheobronchitis (VAT) was found to be 11.6%. Acinetobacter was the most frequently isolated organism (47%) followed by Pseudomonas (28%), Klebsiella (15%), E. coli (5%) and Enterobacter (5%). Risk factors for VAP on bivariate analysis were use of proton pump inhibitor (PPI) (p = 0.027, OR 5.2, 95% CI 1.1-24.3), enteral feeding (p < 0.001, OR 6.5, 95% CI 2.1-19.4) and re-intubation (p = 0.024, OR 3.3 and 95% CI 1.1-9.6). On multivariate analysis, use of PPI (p = 0.03, OR 8.47, 95% CI 1.19-60.33) and enteral feeding (p < 0.001, OR 12.2, 95% CI 2.58-57.78) were identified as independent risk factors for VAP. CONCLUSIONS Ventilator associated pneumonia is an important complication in children receiving mechanical ventilation in PICU and Gram negative bacilli (Acinetobacter and Pseudomonas) being the important causative agents. Ventilator associated tracheobronchitis is an emerging entity; recognition and treatment of same might prevent the development of VAP.
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Affiliation(s)
- Gnanaguru Vijay
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Anirban Mandal
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Jhuma Sankar
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Arti Kapil
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Lodha
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - S K Kabra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India
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Iosifidis E, Pitsava G, Roilides E. Ventilator-associated pneumonia in neonates and children: a systematic analysis of diagnostic methods and prevention. Future Microbiol 2018; 13:1431-1446. [PMID: 30256161 DOI: 10.2217/fmb-2018-0108] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
AIM While ventilator-associated pneumonia (VAP) remains frequent in Pediatric ICU, there is no gold standard for diagnosis. METHODOLOGY We conducted a systematic PUBMED analysis (January 1990-January 2017) searching original, full-length studies addressing only pediatric patients; for VAP diagnosis, only those comparing different diagnostic methods and for VAP prevention those implementing preventive measures. RESULTS Among 367 articles, 17 and 16 were analyzed for diagnosis and prevention, respectively. For diagnosis, 13 studies used CDC criteria; whereas, 14 assessed algorithms: clinical pulmonary index score, ventilator-associated events and biomarkers. Among five randomized trials assessing preventive strategies one found a role of probiotics. Ventilator-care bundles reduced VAP rates. CONCLUSION Absence of diagnostic gold standard impedes comparison of current approaches and preventive strategies.
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Affiliation(s)
- Elias Iosifidis
- Infectious Disease Unit, 3rd Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki Greece
| | - Georgia Pitsava
- Infectious Disease Unit, 3rd Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki Greece
| | - Emmanuel Roilides
- Infectious Disease Unit, 3rd Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki Greece
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Bennett EE, VanBuren J, Holubkov R, Bratton SL. Presence of Invasive Devices and Risks of Healthcare-Associated Infections and Sepsis. J Pediatr Intensive Care 2018; 7:188-195. [PMID: 31073493 DOI: 10.1055/s-0038-1656535] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 04/24/2018] [Indexed: 10/16/2022] Open
Abstract
The present study evaluated the daily risk of healthcare-associated infections and sepsis (HAIS) events in pediatric intensive care unit patients with invasive devices. This was a retrospective cohort study. Invasive devices were associated with significant daily risk of HAIS ( p < 0.05). Endotracheal tubes posed the greatest risk of HAIS (hazard ratio [HR]: 4.39, confidence interval [CI]: 2.59-7.46). Children with both a central venous catheter (CVC) and urinary catheter (UC) had over 2.5-fold increased daily risk (HR: 2.59, CI: 1.18-5.68), in addition to daily CVC risk (HR: 3.06, CI: 1.38-6.77) and daily UC risk (HR: 8.9, CI: 3.62-21.91). We conclude that a multistate hazard model optimally predicts daily HAIS risk.
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Affiliation(s)
- Erin E Bennett
- Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, United States
| | - John VanBuren
- Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, United States
| | - Richard Holubkov
- Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, United States
| | - Susan L Bratton
- Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, United States
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Leone M, Bouadma L, Bouhemad B, Brissaud O, Dauger S, Gibot S, Hraiech S, Jung B, Kipnis E, Launey Y, Luyt CE, Margetis D, Michel F, Mokart D, Montravers P, Monsel A, Nseir S, Pugin J, Roquilly A, Velly L, Zahar JR, Bruyère R, Chanques G. Hospital-acquired pneumonia in ICU. Anaesth Crit Care Pain Med 2018; 37:83-98. [DOI: 10.1016/j.accpm.2017.11.006] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Banjar A, Felemban M, Dhafar K, Gazzaz Z, Al Harthi B, Baig M, Al Khatib K, Zakaria J, Hawsawi K, Isahac L, Akbar A. Surveillance of preventive measures for ventilator associated pneumonia (VAP) and its rate in Makkah Region hospitals, Saudi Arabia. Turk J Med Sci 2017; 47:211-216. [PMID: 28263492 DOI: 10.3906/sag-1510-105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 06/05/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM The present study aimed to assess the VAP rate and to identify VAP prevention activities in public sector hospitals situated in the Makkah Region, Saudi Arabia (SA). MATERIALS AND METHODS In this cross-sectional study, the VAP data from 13 public sector hospitals were collected from January to December 2013 and analyzed using SPSS 16. RESULTS The overall VAP rate in Makkah Region hospitals was 6.89 cases per 1000 ventilator-days. There was a significant difference in VAP rate among the hospitals of the Makkah Region (P < 0.001). There was no significant difference in the VAP rate among hospitals, which were using only one, two, or all three VAP preventive approaches (P = 0.26) accredited by the Joint Commission International (JCI) and Central Board for Accreditation of Health Care Institution (CBAHI) (P = 0.12), and using the form in intensive care units (ICUs) (P = 0.85). There was a significant difference in the VAP rate among hospitals having different bed capacities (P < 0.001), data regularly collected (P = 0.03), and had a team to supervise the VAP project (P = 0.04). CONCLUSION The VAP rate in Makkah Region hospitals is 6.89 cases per 1000 ventilator-days.
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Affiliation(s)
- Ahmad Banjar
- Department of Thoracic Surgery, Al Noor Specialist Hospital, Makkah, Saudi Arabia
| | - Mohammed Felemban
- Department of Quality Management and Patient Safety, Makkah Region, Saudi Arabia
| | - Khalid Dhafar
- Department of General Surgery, Al Noor Specialist Hospital, Makkah, Saudi Arabia
| | - Zohair Gazzaz
- Department of Medicine, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Badr Al Harthi
- Department of Medicine, King Faisal Specialist Hospital, Taif, Saudi Arabia
| | - Mukhtiar Baig
- Department of Clinical Biochemistry, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Kasim Al Khatib
- Department of ICU, Al Noor Specialist Hospital, Makkah, Saudi Arabia
| | - Jameela Zakaria
- Department of Quality Management and Patient Safety, Makkah Region, Saudi Arabia
| | - Kawther Hawsawi
- Department of Nursing, King Faisal Hospital, Makkah, Saudi Arabia
| | - Lilma Isahac
- Department of Nursing, Al Noor Specialist Hospital, Makkah, Saudi Arabia
| | - Arbi Akbar
- Department of Nursing, Hera General Hospital, Makkah, Saudi Arabia
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Hatachi T, Tachibana K, Takeuchi M. Incidences and influences of device-associated healthcare-associated infections in a pediatric intensive care unit in Japan: a retrospective surveillance study. J Intensive Care 2015; 3:44. [PMID: 26509039 PMCID: PMC4621933 DOI: 10.1186/s40560-015-0111-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 10/21/2015] [Indexed: 11/24/2022] Open
Abstract
Background Device-associated healthcare-associated infections (DA-HAIs) are a major problem in pediatric intensive care units (PICUs). However, there are no data available regarding the incidences of DA-HAIs in PICUs in Japan and their influences on length of PICU stay and mortality. The objective of this study was to investigate the incidences of three common DA-HAIs in a PICU and their influences on length of PICU stay and mortality in Japan. Methods We performed a retrospective surveillance study over 12 months in a single PICU in Japan. First, we investigated the incidences of three common DA-HAIs: central line-associated bloodstream infections (CLABSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infection (CAUTI) by chart review, according to the surveillance definitions of the Centers for Disease Control and Prevention/National Healthcare Safety Network. Second, we compared patient characteristics, morbidity, and mortality between the patients with and without DA-HAIs. Results Of all 426 patients admitted to the PICU, 73 % had a central venous catheter, 75 % had an endotracheal tube, and 81 % had a urinary catheter during their PICU stay; the device utilization ratios per patient-days for these were 0.78, 0.53, and 0.44, respectively. In total, 28 patients (6.6 %) acquired at least one of the three DA-HAIs investigated, with an overall incidence per 1000 patient-days of 11.2. The incidences of CLABSI, VAP, and CAUTI per 1000 device-days were 4.3, 3.5, and 13.6, respectively. The median length of PICU stay for the patients with DA-HAIs was 22.5 days, compared with 2 days for those without DA-HAIs. Although there was no statistical difference, the mortality of the patients with DA-HAIs was 7.1 %, whereas the mortality of the patients without DA-HAIs was 2.3 %. Conclusions This study showed the incidences of three common DA-HAIs in a PICU in Japan, and that they were associated with a longer length of PICU stay.
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Affiliation(s)
- Takeshi Hatachi
- Department of Intensive Care Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodocho, Izumi, Osaka 594-1101 Japan
| | - Kazuya Tachibana
- Department of Intensive Care Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodocho, Izumi, Osaka 594-1101 Japan
| | - Muneyuki Takeuchi
- Department of Intensive Care Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, 840 Murodocho, Izumi, Osaka 594-1101 Japan
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Abstract
PURPOSE OF REVIEW Compared with adults, neonatal and pediatric populations are especially vulnerable patients who have specific diagnostic and therapeutic differences; therefore, the standard infection control practices designed for adults are sometimes not effective or need modifications to work. This review focuses on the recent literature addressing the challenges and successes in preventing healthcare-associated infections (HAIs) in children. RECENT FINDINGS Improving the implementation of pediatric versions of preventive bundles focusing on proper catheter insertion and maintenance, mainly as a part of a larger multimodal strategy, is effective in reducing the central-line-associated bloodstream infections in neonatal and pediatric populations including oncology patients. Appropriate feeding, antimicrobial stewardship, and infection control measures should be combined in reducing necrotizing enterocolitis in preterm neonates. Implementing a multimodal bundle strategy adapted for pediatric population is successful in preventing ventilator-associated pneumonia. Appropriate use of antimicrobial prophylaxis remains the cornerstone for preventing surgical-site infections irrespective of age, with few additional effective adjuvant preventive practices in specific pediatric patients. SUMMARY Several evidence-based practices are effective in reducing the incidence and the impact of HAIs in children; however, proper implementation remains a challenge. Additionally, several adult preventive practices are still unestablished in children and need further thorough examination.
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Aelami MH, Lotfi M, Zingg W. Ventilator-associated pneumonia in neonates, infants and children. Antimicrob Resist Infect Control 2014. [DOI: 10.1186/2047-2994-3-30] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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