Multidrug-resistant hospital-associated infections in a pediatric intensive care unit: a cross-sectional survey in a Thai university hospital.
OBJECTIVE
To determine the incidence and associated factors of multidrug-resistant hospital-associated infections (MDR-HAI) in a pediatric intensive care unit (PICU) of a university hospital in Thailand.


METHODS
A prospective study was performed in the PICU of King Chulalongkorn Memorial Hospital during the period May-December 2005. Children aged < or = 15 years who developed a PICU-related HAI were studied.


RESULTS
Forty-four patients (median age 6 months; male:female = 1.4:1) developed 58 episodes of PICU-related HAI. The HAI rate was 28.3 per 1000 patient-days. Thirty episodes (52%) were MDR-HAI. The following were found more frequently in MDR-HAI when compared to non-MDR-HAI: Acinetobacter baumannii (50% vs. 23%, p = 0.04), female sex (60% vs. 29%, p = 0.02), admission to the PICU with a medical condition (90% vs. 64%, p = 0.03), PICU stay longer than 7 days prior to the development of HAI (67% vs. 36%, p = 0.03), and previous use of broad-spectrum antibiotics (83% vs. 43%, p = 0.002). Independent risk factors for MDR-HAI included female sex (OR = 5.5, p = 0.03) and previous use of a broad-spectrum antibiotic (OR = 9.7, p = 0.01).


CONCLUSIONS
The incidence of MDR-HAI was high in the PICU. Female sex and previous use of a broad-spectrum antibiotic were independent risk factors for MDR-HAI.
Sritippayawan
Suchada
S
Division of Pulmonology and Critical Care, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Rama IV Rd, Bangkok 10330, Thailand. suchadacu@hotmail.com
Sri-Singh
Klaita
K
Prapphal
Nuanchan
N
Samransamruajkit
Rujipat
R
Deerojanawong
Jitladda
J
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology
D000900:Anti-Bacterial Agents