Revista da Sociedade Brasileira de Medicina Tropical (Aug 2012)

Nosocomial infections in a pediatric intensive care unit of a developing country: NHSN surveillance

  • Juliana Pena Porto,
  • Orlando Cesar Mantese,
  • Aglai Arantes,
  • Claudete Freitas,
  • Paulo Pinto Gontijo Filho,
  • Rosineide Marques Ribas

DOI
https://doi.org/10.1590/s0037-86822012005000003
Journal volume & issue
Vol. 45, no. 4
pp. 475 – 479

Abstract

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INTRODUCTION: This study aimed to determine the epidemiology of the three most common nosocomial infections (NI), namely, sepsis, pneumonia, and urinary tract infection (UTI), in a pediatric intensive care unit (PICU) in a developing country and to define the risk factors associated with NI. METHODS: We performed a prospective study on the incidence of NI in a single PICU, between August 2009 and August 2010. Active surveillance by National Healthcare Safety Network (NHSN) was conducted in the unit and children with NI (cases) were compared with a group (matched controls) in a case-control fashion. RESULTS: We analyzed 172 patients; 22.1% had NI, 71.1% of whom acquired it in the unit. The incidence densities of sepsis, pneumonia, and UTI per 1,000 patients/day were 17.9, 11.4, and 4.3, respectively. The most common agents in sepsis were Enterococcus faecalis and Escherichia coli (18% each); Staphylococcus epidermidis was isolated in 13% of cases. In pneumonias Staphylococcus aureus was the most common cause (3.2%), and in UTI the most frequent agents were yeasts (33.3%). The presence of NI was associated with a long period of hospitalization, use of invasive devices (central venous catheter, nasogastric tube), and use of antibiotics. The last two were independent factors for NI. CONCLUSIONS: The incidence of NI acquired in this unit was high and was associated with extrinsic factors.

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