title: Nosocomial infections in a pediatric intensive care unit of a developing country: NHSN surveillance.
abstract: BACKGROUND
  This study aimed to determine the epidemiology of the three most common nosocomial infections (NI), namely, sepsis, pneumonia, and urinary tract infection (UTI), in a pediatric intensive care unit (PICU) in a developing country and to define the risk factors associated with NI.
  
  
  METHODS
  We performed a prospective study on the incidence of NI in a single PICU, between August 2009 and August 2010. Active surveillance by National Healthcare Safety Network (NHSN) was conducted in the unit and children with NI (cases) were compared with a group (matched controls) in a case-control fashion.
  
  
  RESULTS
  We analyzed 172 patients; 22.1% had NI, 71.1% of whom acquired it in the unit. The incidence densities of sepsis, pneumonia, and UTI per 1,000 patients/day were 17.9, 11.4, and 4.3, respectively. The most common agents in sepsis were Enterococcus faecalis and Escherichia coli (18% each); Staphylococcus epidermidis was isolated in 13% of cases. In pneumonias Staphylococcus aureus was the most common cause (3.2%), and in UTI the most frequent agents were yeasts (33.3%). The presence of NI was associated with a long period of hospitalization, use of invasive devices (central venous catheter, nasogastric tube), and use of antibiotics. The last two were independent factors for NI.
  
  
  CONCLUSIONS
  The incidence of NI acquired in this unit was high and was associated with extrinsic factors.
authors: Programa de Pós-graduação em Imunologia e Parasitologia Aplicadas, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brasil. ju-nana@hotmail.com
authors: Juliana Pena
authors: JP
authors: Porto
authors: Orlando Cesar
authors: OC
authors: Mantese
authors: Aglai
authors: A
authors: Arantes
authors: Claudete
authors: C
authors: Freitas
authors: Paulo Pinto
authors: PP
authors: Gontijo Filho
authors: Rosineide Marques
authors: RM
authors: Ribas
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002648:Child; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004812:Epidemiologic Methods; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000302:isolation & purification*; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D008297:Male; D018410:Pneumonia, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D018805:Sepsis / Q000453:epidemiology* / Q000382:microbiology; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology