title: [Analysis of nosocomial pediatric bacteremias at a general hospital between 1990 and 2006. The impact of attending the intravascular therapy].
abstract: BACKGROUND
  The administration of parenteral infusates is a frequent intervention that is considered innocuous; moreover, the risk of this procedure which offers a direct access to the bloodstream is minimized.
  
  
  OBJECTIVE
  To evaluate the epidemiology of nosocomial pediatric bacteremias after implementing a control program.
  
  
  METHODS
  Analysis of pediatric bacteremias was made in 3 periods: 1) 1990-1992, prior to establishing strategies to avoid contamination of parenteral infusions; 2) 1996, the phase after establishing these strategies; and 3) 2005-2006, the recent situation in the hospital.
  
  
  RESULTS
  The proportion of gram-negative rods isolated in blood cultures dropped from 82.9 to 35.1% (p = 0.004) during the 17-year study period. There was no significant difference in the proportion of gram-negative rods isolated from intravascular catheters. The proportion of contaminated parenteral infusions dropped from 22.2% to 0.4% (p < 0.001).
  
  
  CONCLUSIONS
  The strategies established to avoid the contamination of parenteral infusions were associated with a reduction in the proportion of gram-negative rods in blood cultures, although the proportion is still higher than that in developed countries, probably related to catheter contamination. We suggest establishing similar strategies in other hospitals from developing countries.
authors.affiliation: Universidad de Guanajuato. luis_mosqueda@yahoo.com
authors.forename: Juan L
authors.initials: JL
authors.lastname: Mosqueda-Gómez
authors.forename: José A
authors.initials: JA
authors.lastname: Alvarez
authors.forename: Juan M
authors.initials: JM
authors.lastname: Muñoz
authors.forename: Celia
authors.initials: C
authors.lastname: Alpuche
authors.forename: Samuel
authors.initials: S
authors.lastname: Ponce-de-León
authors.forename: José A
authors.initials: JA
authors.lastname: Córdova
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D004269:DNA, Bacterial / Q000235:genetics; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D006769:Hospitals, General / Q000458:organization & administration / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000458:organization & administration; D007262:Infusions, Intravenous; D007710:Klebsiella Infections / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D007711:Klebsiella pneumoniae / Q000235:genetics / Q000302:isolation & purification; D008800:Mexico / Q000453:epidemiology; D015397:Program Evaluation; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial