Prevalence of nosocomial infections in Swiss children's hospitals.
OBJECTIVE
To acquire data on pediatric nosocomial infections (NIs), which are associated with substantial morbidity and mortality and for which data are scarce.


METHODS
Prevalence survey and evaluation of a new comorbidity index.


METHODS
Seven Swiss pediatric hospitals.


METHODS
Those hospitalized for at least 24 hours in a medical, surgical, intensive care, or intermediate care ward.


RESULTS
Thirty-five NIs were observed among 520 patients (6.7%; range per hospital, 1.4% to 11.8%). Bacteremia was most frequent (2.5 per 100 patients), followed by urinary tract infection (1.3 per 100 patients) and surgical-site infection (1.1 per 100 patients; 3.2 per 100 patients undergoing surgery). The median duration until the onset of infection was 19 days. Independent risk factors for NI were age between 1 and 12 months, a comorbidity score of 2 or greater, and a urinary catheter. Among surgical patients, an American Society of Anesthesiologists (ASA) score of 2 or greater was associated with any type of NI (P = .03). Enterobacteriaceae were the most frequent cause of NI, followed by coagulase-negative staphylococci; viruses were rarely the cause.


CONCLUSIONS
This national prevalence survey yielded valuable information about the rate and risk factors of pediatric NI. A new comorbidity score showed promising performance. ASA score may be a predictor of NI. The season in which a prevalence survey is conducted must be considered, as this determines whether seasonal viral infections are observed. Periodic prevalence surveys are a simple and cost-effective method for assessing NI and comparing rates among pediatric hospitals.
University Hospital, Bern, Switzerland.
Kathrin
K
Mühlemann
Christine
C
Franzini
Christoph
C
Aebi
Christoph
C
Berger
David
D
Nadal
Jody
J
Stähelin
Hanspeter
H
Gnehm
Klara
K
Posfay-Barbe
Alain
A
Gervaix
Hugo
H
Sax
Ulrich
U
Heininger
Jan
J
Bonhoeffer
Gerhard
G
Eich
Christian
C
Kind
Christiane
C
Petignat
Pietro
P
Scalfaro
D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011159:Population Surveillance; D015995:Prevalence; D013557:Switzerland / Q000453:epidemiology