Nosocomial infection in a pediatric intensive care unit in a developing country.
OBJECTIVE
Determine the rate and outcome of nosocomial infection (NI) in pediatric intensive care unit patients in a developing country.


METHODS
Prospective cohort study using the Centers for Disease Control and Prevention definitions to diagnose nosocomial infection and NNISS (National Nosocomial Infection Surveillance System) methodology.


METHODS
São Paulo Hospital - Universidade Federal de São Paulo - Brazil, a 700-bed teaching hospital with an 8-bed pediatric intensive care unit.


METHODS
All 515 children consecutively admitted to the pediatric intensive care unit from April 1996 to October 1997.


RESULTS
The NI incidence was 18.3% and the mean infection rate per 1,000 patient days was 46.1; the ventilator-associated pneumonia rate was 18.7 per 1,000 ventilator days; the central line-associated bloodstream infection rate was 10.2 per 1,000 central line days; and the urinary tract catheter-associated infection rate was 1.8 per 1,000 catheter days. Pneumonia was the most common NI (31.6%), followed by bloodstream infections (17.3%), and surgical site infection (17.3%). Gram-negative bacterias were the most common pathogens identified in the NIs (54.8%), followed by Gram-positive bacterias (23.8%), and yeasts.


CONCLUSIONS
Pneumonia was the most common type of NI. A high incidence of ventilator-associated pneumonia and central line-associated bloodstream infections was found, whereas the urinary tract catheter-associated infection rate was low. Gram-negative bacterias were the most common etiologic agents identified in the unit, and yeasts were frequently found. Pediatric patients have characteristics of their own, with major differences when compared to the adult population.
Abramczyk
Marcelo L
ML
Hospital São Paulo, Federal University of São Paulo, São Paulo, Brazil.
Carvalho
Werther B
WB
Carvalho
Eduardo S
ES
Medeiros
Eduardo A S
EA
D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D003906:Developing Countries; D004812:Epidemiologic Methods; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay