Active surveillance of hospital-acquired infections in Pediatric Intensive Care Unit: a single center study.

Objective: The aim of our study was to describe and analyze HAI incidence, etiology and risk factors in pediatric intensive care unit (ICU).

Background: Intensive care patients are at high risk of hospital-acquired infections (HAI) due to their underlying diseases and exposure to invasive devices.

Methods: The study group consisted of patients admitted to children's hospital ICU for more than 2 days during a six-month period (267 patients, 1570 patient-days). We used the European Centre for Disease Prevention and Control standard protocol HAI-Net ICU v2.2 for data collection.

Results: HAI occurred in 17 (6.4%) included patients (10.8 infections per 1000 patient-days). The most frequent were catheter-related bloodstream infections (33%, 7.6 per 1000 catheter-days) and intubation-associated pneumonia (25%, 10.9 per 1000 intubation-days). Gram-negative bacteria (Pseudomonas aeruginosa, Klebsiella spp.) were identified as the most common etiological agents. Significantly higher risk of HAI had patients with central venous catheter (OR: 14.5, 95% CI 3.2-65.1), intubated (OR: 14.4, 95% CI 4.4-46.2), with Pediatric Index of Mortality score higher than 10 (OR: 17, 95% CI 2.7-111.5) and with previous bacterial or/ and fungal colonization (OR: 30.6, 95% CI 9.2-101.3).

Conclusions: Active surveillance identified unreported HAI cases and proved to be an effective tool of infection control.