Nosocomial infections among pediatric hematology/oncology patients: results of a prospective incidence study.
BACKGROUND
Nosocomial infections (NI) are an important clinical complication in adult and children patients at the different hospital wards. NI cause considerable morbidity and mortality and are associated with prolonged hospital stay and increased health care costs.


OBJECTIVE
The objective of this study was to describe the incidence of NI in pediatric patients with neoplastic disease as a first step toward improving infection control policies.


METHODS
A prospective surveillance study from March through May 2001 was performed in the pediatric hematology/oncology unit at the University Hospital in Barcelona. The Centers for Disease Control and Prevention criteria were used as standard definition for NI. NI rates were calculated as a density incidence rate (per 100 patient-days).


RESULTS
Fifty-one patients were admitted during the study period. Twelve patients had a total of 18 NI. The incidence of NI was 1.77 per 100 patient-days. Patients with acute lymphoblastic leukemia had the highest NI rate (2.71 per 100 patient-days). The most frequent episodes of NI were bacteremia (55.5%) and fever of unknown origin (16.6%). The most frequently isolated microorganisms were gram-positive bacteria (78.6%). Coagulase-negative Staphylococci were the most common isolates in bacteremias (70%). The extrinsic risk factors related with the highest incidence rates of NI per 100 patient-days were central venous catheterization (1.7 infections) and parenteral nutrition (3.2 infections).


CONCLUSIONS
Extrinsic risk factors associated with NI have been identified in this high-risk population. These findings suggest the need to evaluate the infection control measures to reduce the morbidity and mortality in a hematology/oncology unit.
Urrea
Mireya
M
Quality Service-Infection Hospital Program, Hospital Sant Joan de Déu, Barcelona, Spain.
Rives
Susana
S
Cruz
Ofelia
O
Navarro
Albert
A
García
Juan José
JJ
Estella
Jesús
J
D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology; D019337:Hematologic Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D017053:Infection Control; D015278:Intensive Care Units, Pediatric; D008297:Male; D010372:Pediatrics; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate