title: Prospective study estimating healthcare associated infections in a paediatric hemato-oncology unit of a tertiary care hospital in North India.
abstract: OBJECTIVE
  Healthcare associated infections (HAIs) are responsible for morbidity and mortality among immunocompromised and critically ill patients. We undertook this study to estimate the burden of HAIs in the paediatric cancer patients in a tertiary care hospital in north India.
  
  
  METHODS
  This prospective, observational study, based on active surveillance for a period of 11 months was undertaken in a 4-bedded isolated, cubicle for paediatric cancer patients. Patients who stayed in the cubicle for ≥48 h, were followed prospectively for the development of HAIs.
  
  
  RESULTS
  Of the 138 patients, 13 developed 14 episodes of HAIs during the study period. Patient-days calculated were 1273 days. Crude infection rate (CIR) and incidence density (ID) of all HAIs were 9.4/100 patients and 11/1000 patient-days, respectively. Of the 14 episodes of HAIs, seven (50%) were of blood stream infections (HA-BSI), five (36%) of pneumonia (HAP) and two (14%) urinary tract infections (HA-UTI). The CIRs of HA-BSI, HAP and HA-UTI were 5.1, 3.6 and 1.4/100 patients, respectively. The corresponding IDs were 5.5, 3.9 and 1.6/1000 patient-days, respectively. Mean length of stay was significantly higher in patients who developed an HAI [13.8 (range 7-30), median (Interquartile range) 12 (11-14)] vs 7.5 days [range 2-28, median (interquartile range) 7 (5-9); P<0.0001]. Also mortality was significantly higher in patients who developed an HAI [23% (3/13) vs 3% (4/125), P<0.05].
  
  
  CONCLUSIONS
  The incidence of HAIs in the paediatric cancer patients in the study was 11/1000 patient days, of which HA-BSIs were the commonest. HAIs were associated with an increase in morbidity and mortality amongst this high risk patient population.
authors: Ayush
authors: A
authors: Gupta
authors: Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
authors: Arti
authors: A
authors: Kapil
authors: S K
authors: SK
authors: Kabra
authors: Rakesh
authors: R
authors: Lodha
authors: Seema
authors: S
authors: Sood
authors: Benu
authors: B
authors: Dhawan
authors: Bimal K
authors: BK
authors: Das
authors: V
authors: V
authors: Sreenivas
mesh_terms: D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D011446:Prospective Studies; D012307:Risk Factors; D063128:Tertiary Health Care