An Evaluation of Pediatric Intensive Care Unit Infection Rates and Various Risk Factors

Abstract

INTRODUCTION: The pediatric intensive care unit (PICU) is a unit in which the general condition and vital signs of patients aged one month to 18 years are continuously monitored, and support treatments after advanced pediatric and surgical procedures are provided. Healthcare-associated infections (HAIs) can develop during some interventions and treatments. The purpose of this study was to investigate infection and handwashing rates for the previous five years in a hospital PICU providing tertiary intensive care and to examine HAI agent microorganisms and their resistance rates. METHODS: Data for patients followed-up at the Aydın Adnan Menderes University Hospital PICU between 1 January 2015, and 30 October 2020, were examined retrospectively. The study data were obtained from the hospital microbiology laboratory culture specimen results, radiology data, clinical visits, and information recorded on the National Healthcare-Associated Infections Surveillance System. HAIs rates, density, infectious agents and resistance rates, and hand hygiene compliance rates were calculated from these data. RESULTS: Two hundred and thirty-three patients were included in the study. The mean annual number of patient days was 1742±322. The mean annual total number of infections was 9.0±3.9, the mean infection rate was 4.2±2.8, and the mean infection density was 5.0±1.5. Bloodstream infections constituted the most common infections, followed by ventilator-associated pneumonia (VAP). Carbapenem resistance at a rate of 50% was determined for both Acinetobacter spp. and Pseudomonas aeruginosa. A strong correlation was determined between VAP and patient days (p=0.05, r=0.80). Hand hygiene observations revealed compliance rates of 48.1±14.3 in nurses, 33.9±28.2 in patient carers, 31.8±12.5 in physicians, and 30.9±26.2 in cleaning personnel DISCUSSION AND CONCLUSION: Mean annual infection numbers in this study were similar to those of previous studies from other centers. The most common infection was bloodstream infections. Nurses had the highest handwashing rates, with physicians in the third place. Higher VAP was correlated with increased patient days.