Introduction Healthcare-associated infections (HAI) are a common cause of higher morbidity, mortality and longer stay in PICU.
Objective Characterisation of HAI: tracheobronchitis, pneumonia, bloodstream infection (BSI) and urinary tract infection (UTI) in our PICU, for a 12 month period (2013).
Methods Retrospective review of clinical data from patients admitted >48 h, using a modified patient-based HELICS protocol. HAI was defined according to the Centre for Disease Control.
Results From a total of 450 admissions, 233 patients were included. Mean age was 6,7 years (0–18), mean length of stay was 6,6 days (3–67), and the majority had antibiotic on admission (87%). Seventy one patients (31%) were mechanically ventilated, 41% had CVC and 33% a urinary catheter.
Fifteen children had a total of 21 HAI (9%): 16 respiratory infections - 13 pneumonias and 3 tracheobronchitis (19,8 and 4,6/1000 days of ventilation, respectively), 2 primary BSI – one related to CVC (1,4/1000 days of CVC) and 3 UTI (2,9/1000 days of urinary catheter). The most common pathogens were Pseudomonas aeruginosa and Enterobacter cloacae in respiratory infections. Staphylococcus hominis and Candida parapsilosis were identified in BSI and Escherichia coli, Enterococcus faecalis, Candida parapsilosis in UTI. Mean length of stay was 26,9 days in the HAI group versus 5,2 days in non HAI group. There was no HAI related mortality.
Discussion The incidence of HAI was similar to other European Units. We found a higher rate of respiratory infections than that of a previous study in our PICU, emphasising the importance of monitoring and preventive measures.