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Prevalence of Nosocomial Infections in Swiss Children's Hospitals

  • Kathrin Mühlemann (a1), Christine Franzini (a1), Christoph Aebi (a1), Christoph Berger (a2), David Nadal (a2), Jody Stähelin (a3), Hanspeter Gnehm (a3), Klara Posfay-Barbe (a4), Alain Gervaix (a4), Hugo Sax (a5), Ulrich Heininger (a6), Jan Bonhoeffer (a6), Gerhard Eich (a7), Christian Kind (a7), Christiane Petignat (a8) and Pietro Scalfaro (a8)...

Abstract

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.

Copyright

Corresponding author

Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, CH-3010 Bern, Switzerland

References

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Prevalence of Nosocomial Infections in Swiss Children's Hospitals

  • Kathrin Mühlemann (a1), Christine Franzini (a1), Christoph Aebi (a1), Christoph Berger (a2), David Nadal (a2), Jody Stähelin (a3), Hanspeter Gnehm (a3), Klara Posfay-Barbe (a4), Alain Gervaix (a4), Hugo Sax (a5), Ulrich Heininger (a6), Jan Bonhoeffer (a6), Gerhard Eich (a7), Christian Kind (a7), Christiane Petignat (a8) and Pietro Scalfaro (a8)...

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