Evaluation of healthcare associated infections at pediatric critical care units

Objective: Health-care associated infection (HAI) constitutes a major health care problem resulting in prolonged hospital stay with increased medical costs. The burden is much greater by accompanying risk factors among intensive care admissions. The incidence is reported 30% of all ICU admissions in developed countries; however the estimated rates are clearly higher in developing countries3. In order to prevent HAIs, the health-care facilities should determine their own risk factors, analyse the microorganisms isolated from the body fluids and provide the necessary precautions accordingly5. Despite all the efforts and the advances at preventive protocols, the HAI burden still exits. The pediatric intensive care unit (PICU) of Sivas Cumhuriyet University Hospital is a tertiary critical care unit serving to a broad range of population under 18 years with highly advanced technology within a considerably populated territory. The demographic profiles of the admissions account a wide range of childhood sicknesses from trauma to neurological disorders. The aim of this retrospective study was to examine the microorganism profiles isolated from the body fluids (blood, urine, tracheal aspirates, wound cultures, spinal fluid) of all PICU admissions during the past five years. Hence we decided to obtain our local surveillance data, deploy the necessary precautions to decline HAIs and administer the appropriate antimicrobial therapy accordingly. Method: In this retrospective descriptive study, we searched the medical records of all PICU admissions between January 2014 and December 2018. Children with i) PICU admission lasting over 48 hours, ii) culture positiviy at body fluids, iii) presenting clinical signs of infection were enrolled in the study. Patient demographics, initial complaints, admission diagnosis, the underlying chronical conditions, the source of PICU admission (admission from an indoor clinic, emergency service or an outdoor clinic) and previous hospitalizations were all recorded. We recalled HAI subgroups according to the definitions of centers for disease control and prevention (CDC)6 such as: ventilator-associated pneumonia (VAP), blood stream infection (BSI), central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTI) and surgical site infections (SSI). SPSS-23 (Statistical Package for Social Sciences for Windows 23) was used for statics of the study. Descriptive analyses were expressed as percentages, mean±standart deviation (SD), median with minimum and maximum values. Chi square and Fischer