Do isolation rooms reduce the rate of nosocomial infections in the pediatric intensive care unit?
OBJECTIVE
To determine the effect of isolation rooms on the direct spread of nosocomial infections (NIs) owing to cross-colonization in a pediatric intensive care unit (PICU).


METHODS
This 6-month comparative clinical study used retrospective data from 1992 (an open single-space unit) and prospective surveillance from 1995 (individual rooms) to assess the effectiveness of the latter design on the control of NIs in critically ill pediatric patients. Patients admitted to the PICU for at least 48 hours underwent a microbiologic survey.


RESULTS
The average number of NIs per patient was higher in 1992 (3.62 +/- 0.7, 78 patients) compared with 1995 (1.87 +/- 0.2, 115 patients). Bacterial NIs were caused by gram-positive cocci (33.3%) and aerobic gram-negative bacilli (66.6%). Fungemia in all cases was caused by Candida albicans. Similarly, length of stay was significantly higher in 1992 compared with 1995 (25 +/- 6 and 11 +/- 6 days, respectively; P <.05). There was a significant reduction of respiratory and urinary tract episodes of NI as well as catheter-related infections in the separate room arrangement.


CONCLUSIONS
Our preliminary analysis suggests a possible beneficial effect of single isolation rooms in reducing NI rate in the PICU. Hence, the influence of room isolation on NIs in pediatric intensive care warrants further investigation.
Ben-Abraham
Ron
R
Department of Anesthesiology, Tel-Aviv Sourasky Medical Center, Saclker Faculty of Medicine, Tel Aviv University, Israel.
Keller
Natan
N
Szold
Oded
O
Vardi
Amir
A
Weinberg
Marius
M
Barzilay
Zohar
Z
Paret
Gideon
G
D002177:Candidiasis / Q000453:epidemiology; D002648:Child; D002673:Child, Hospitalized / Q000706:statistics & numerical data; D002675:Child, Preschool; D003422:Critical Care / Q000379:methods / Q000592:standards*; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology; D006746:Hospital Bed Capacity, 500 and over; D006749:Hospital Design and Construction; D006785:Hospitals, University; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000592:standards*; D015278:Intensive Care Units, Pediatric; D007557:Israel / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D017063:Outcome Assessment, Health Care; D010356:Patient Isolation; D011446:Prospective Studies; D012189:Retrospective Studies