[Epidemiology of nosocomial bacterial infections in a neonatal and pediatric Tunisian intensive care unit].
OBJECTIVE
The authors had for aim to describe the epidemiology of nosocomial bacterial infections in the neonatal and pediatric intensive care unit of the Tunis children's hospital.


METHODS
A prospective surveillance study was made from January 2004 to December 2004. All patients remaining in the intensive care unit for more than 48 h were included. CDC criteria were applied for the diagnosis of nosocomial infections.


RESULTS
340 patients including 249 (73%) neonates were included. 22 patients presented with 22 nosocomial bacterial infections. The incidence and the density incidence rates of nosocomial bacterial infections were 6.5% and 7.8 per 1,000 patient-days, respectively. Two types of infection were found: bloodstream infections (68.2%) and pneumonias (22.7%). Bloodstream infections had an incidence and a density incidence rate of 4.4% and 15.3 per 1,000 catheter-days, respectively. Pneumonia had an incidence and a density incidence rate of 2% and 4.4 per 1,000 mechanical ventilation-days, respectively. The most frequently isolated pathogens were Gram-negative bacteria (68%) with Klebsiella pneumoniae isolates accounting for 22.7%. The most common isolate in bloodstream infections was K. Pneumoniae (26.7%), which was multiple drug-resistant in 85% of the cases, followed by Staphylococcus aureus (20%). Pseudomonas aeruginosa was the most common isolate in pneumonia (28.6%). Associated factors of nosocomial infection were invasive devices and colonization with multiple drug-resistant Gram-negative bacteria.


CONCLUSIONS
The major type of nosocomial bacterial infections in our unit was bloodstream infection and the majority of infections resulted from Gram-negative bacteria. Factors associated with nosocomial bacterial infections were identified in our unit.
Ben Jaballah
N
N
Service de réanimation pédiatrique polyvalente, hôpital d'enfants de Tunis, place Bab-Saadoun, 1007 Tunis-Jebbari, Tunisie. nejla.benjaballah@rns.tn
Bouziri
A
A
Kchaou
W
W
Hamdi
A
A
Mnif
K
K
Belhadj
S
S
Khaldi
A
A
Kazdaghli
K
K
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000145:classification / Q000453:epidemiology*; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000145:classification / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D007363:Intensive Care Units, Neonatal; D008297:Male; D014416:Tunisia / Q000453:epidemiology; D014481:United States