A national point-prevalence survey of pediatric intensive care unit-acquired infections in the United States.
OBJECTIVE
To determine the prevalence of intensive care unit-acquired infections, a major cause of morbidity in pediatric intensive care unit (PICU) patients.


METHODS
Pediatric Prevention Network hospitals (n = 31) participated in a point-prevalence survey on August 4, 1999. Data collected for all PICU inpatients included demographics, infections, therapeutic interventions, and outcomes.


RESULTS
There were 512 patients in 35 PICUs. The median age was 2.2 years (range, <1 day-35.4 years). Seventy-five PICU-acquired infections occurred among 61 (11.9%) patients. The most frequently reported sites were bloodstream (31 [41.3%]), lower respiratory tract (17 [22.7%]), urinary tract (10 [13.3%]), or skin/soft tissue (6 [8.0%]). The most frequent pathogens were coagulase-negative staphylococci (in 16 [21.3%] infections), Candida spp. (13 [17.3%]), enterococci (10 [13.3%]), Staphylococcus aureus (9 [12.0%]), or Pseudomonas aeruginosa (8 [10.7%]). Age-adjusted risk factors for infection included central intravenous catheters (relative risk [RR], 4.1; 95% confidence intervals [CI], 2.4-7.1), arterial catheters (RR, 2.4; 95% CI, 1.5-3.9), total parenteral nutrition (RR, 5.5; 95% CI, 3.6-8.5), or mechanical ventilation (RR, 3.9; 95% CI, 2.2-6.8). Infection was associated with higher age-adjusted risk of death within 4 weeks of the survey (RR, 3.4; 95% CI, 1.7-6.5).


CONCLUSIONS
This national multicenter study documented the high prevalence of PICU-acquired infections. Preventing these infections should be a national priority.
Grohskopf
Lisa A
LA
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Atlanta, Georgia, USA.
Sinkowitz-Cochran
Ronda L
RL
Garrett
Denise O
DO
Sohn
Annette H
AH
Levine
Gail L
GL
Siegel
Jane D
JD
Stover
Beth H
BH
Jarvis
William R
WR
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000453:epidemiology / Q000628:therapy; D002170:Canada / Q000453:epidemiology; D018929:Cell Culture Techniques; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000628:therapy; D003625:Data Collection; D005260:Female; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D015995:Prevalence; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000628:therapy; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology