title: Health-associated infections in a pediatric nephrology unit in China.
abstract: BACKGROUND
  Health care-associated infection (HAI) in children is associated with morbidity and mortality, prolonged hospital stay, and increased health care costs. We report the prevalence of HAIs in children admitted to the pediatric nephrology unit of a large tertiary care pediatric hospital in China between 2000 and 2008.
  
  
  METHODS
  A prospective infection control surveillance program led by physicians identified HAIs in admitted patients and sent monthly summary data to the hospital's Nosocomial Infections Committee. Infections at any body site meeting the Center for Disease Control and Prevention's former National Nosocomial Infection Surveillance System definitions were eligible for inclusion. Over the study period, various infection prevention and control strategies were introduced, including education on hand hygiene, measures to ensure appropriate antimicrobial prophylaxis for patients, and a guideline for antibiotic use.
  
  
  RESULTS
  Of the 971 patients admitted, 81 had a total of 89 episodes of HAI (9.16%; 89/971); 75 patients (92.6%) had one HAI. The percentage of children acquiring HAI decreased from 12% to 6% over the observation period, representing a statistically significant linear trend. The most common type of HAI was respiratory tract infection (65.16%; n = 58), followed by gastrointestinal tract infection (11.24%; n = 10), skin and soft tissue infection (8.99% (n = 8), bloodstream infection (7.87%; n = 7), and urinary tract infection (6.74%; n = 6).
  
  
  CONCLUSIONS
  The incidence of HAI in a pediatric nephrology ward decreased over an 8-year period, associated with a surveillance program and education directed at hand hygiene and appropriate antibiotic use. Despite a strict visitor policy, respiratory tract infection was the most common HAI seen.
authors.affiliation: Department of Pediatrics, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu, China.
authors.forename: Qingli
authors.initials: Q
authors.lastname: Zhang
authors.forename: Xiaonan
authors.initials: X
authors.lastname: Xu
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Langley
authors.forename: Baoquan
authors.initials: B
authors.lastname: Zhu
authors.forename: Ni
authors.initials: N
authors.lastname: Zhang
authors.forename: Yuying
authors.initials: Y
authors.lastname: Tang
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006235:Hand Disinfection; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D007223:Infant; D017053:Infection Control / Q000379:methods; D008297:Male; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents