ABSTRACT
Introduction:
Nosocomial bloodstream infection (BSI) is an important problem in pediatric intensive care unit (PICU) due to high mortality rates, increased hospitalization and costs. We aimed to define the risk factors, incidence and the microorganisms of BSI in PICU in the present study.
Methods:
The patients admitted to Dokuz Eylül University PICU between January 2011 and January 2013 and stayed in hospital more than 48 hours were evaluated. The patients who had nosocomial BSI were determined and compared with the patients who did not have nosocomial infection during their hospitalization in terms of demographic data, hospitalization diagnoses and underlying chronic diseases, and the treatments applied. Microorganisms isolated in blood culture were also recorded.
Results:
Two hundred fifty two patients were admitted to the study and fifty-eight BSI episodes developed, 55% of population were male (M/F: 1.2) and the median of age was 10 months. The incidence rate of bloodstream infection was 14.7 per 1.000 patient-days. The median duration in PICU for development of BSI was 16.5 days. Nosocomial BSI was more common in patients with central venous catheter, mechanical ventilation, use of steroid treatments. In the presence of congenital heart disease, metabolic disease, neurological disease or genetic syndrome, the frequency of nosocomial BSI was increased. Risk factors for nosocomial BSI were genetic syndrome and longer hospitalization in PICU. The most common isolated agents were coagulase-negative Staphylococcus (48%), Klebsiella spp. (24%), Enterobacter spp. (9%) and Candida spp. (9%).
Conclusion:
It is important to know the risk factors for BSIs and taking precautions in this direction is particularly important in terms of reducing treatment costs and mortality. Since the risk increases as the number of days spent in intensive care increases, the length of stay should be kept as short as possible.
Keywords:
Nosocomial infection, bloodstream infection, sepsis
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