title: Trends in nosocomial infections and multidrug-resistant microorganisms in Spanish pediatric intensive care units.
abstract: BACKGROUND
  Nosocomial infections (NI) are a major healthcare problem. National surveillance systems enable data to be compared and to implement new measures to improve our practice.
  
  
  METHODS
  A multicentre, prospective, descriptive and observational study was conducted using the data from surveillance system for nosocomial infections created in 2007 for Spanish pediatric intensive care units. Data were collected for one month, between 01 and 31 March, for every study year (2008-2012). The objective was to report 5-years of NI surveillance data, as well as trends in infections by multidrug resistant organisms in Spanish pediatric intensive care units.
  
  
  RESULTS
  A total of 3667 patients were admitted to the units during the study period. There were 90 (2.45%) patients with nosocomial infections. The mean rates during the 5 years study were: central line-associated bloodstream infection, 3.8/1000 central venous catheter-days, Ventilator-associated pneumonia 7.5/1000 endotracheal tube-days, and catheter-associated urinary tract infections 4.1/1000 urinary catheter-days. The comparison between the 2008 and 2009 rates for nosocomial infections did not show statistically significant differences. All rates homogeneously decreased from 2009 to 2012: central line-associated bloodstream infection 5.83 (95% CI 2.67-11.07) to 0.49 (95% CI 0.0125-2.76), P=0.0029; ventilator-associated pneumonia 10.44 (95% CI 5.21-18.67) to 4.04 (95% CI 1.48-8.80), P=0.0525; and Catheter-associated urinary tract infections 7.10 (95% CI 3.067-13.999) to 2.56 (95% CI 0.697-6.553), P=0.0817; respectively. The microorganism analysis: 63 of the 99 isolated bacteria (63.6%) were Gram-negative bacteria (36.5% were resistant), 19 (19.2%) Gram-positive bacteria, and 17 (17.2%) were Candida spp. infections.
  
  
  CONCLUSIONS
  The local surveillance systems provide information for dealing with nosocomial infections rates.
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain. Electronic address: ijordan@hsjdbcn.org.
authors.forename: Iolanda
authors.initials: I
authors.lastname: Jordan Garcia
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Esteban Torné
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Amaya
authors.initials: A
authors.lastname: Bustinza Arriortua
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Son Espases, Palma, Mallorca, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: de Carlos Vicente
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Regional Universitario Carlos Haya de Málaga, Málaga, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: García Soler
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: José Andrés
authors.initials: JA
authors.lastname: Concha Torre
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Puerta del Mar de Cádiz, Cádiz, Spain.
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Flores González
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Infantil Universitario Miguel Servet de Zaragoza, Zaragoza, Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: Madurga Revilla
authors.affiliation: Unidad de Medicina Intensiva, Hospital Universitario Arnau de Vilanova de Lleida, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Palomar Martínez
mesh_terms: D000293:Adolescent; D002175:Candida / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D015278:Intensive Care Units, Pediatric; D008297:Male; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000453:epidemiology
keywords: Microorganismos multirresistentes; Multidrug resistant microorganisms; Nosocomial; Pediatric; Pediátrico; Rates; Surveillance; Tasas; Vigilancia