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Prevalence of Nosocomial Infections in Swiss Children's Hospitals

Published online by Cambridge University Press:  02 January 2015

Kathrin Mühlemann ,
Christine Franzini ,
Christoph Aebi ,
Christoph Berger ,
David Nadal ,
Jody Stähelin ,
Hanspeter Gnehm ,
Klara Posfay-Barbe ,
Alain Gervaix  and
Hugo Sax
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Kathrin Mühlemann*
Affiliation:
University Hospital, Bern, Switzerland
Christine Franzini
Affiliation:
University Hospital, Bern, Switzerland
Christoph Aebi
Affiliation:
University Hospital, Bern, Switzerland
Christoph Berger
Affiliation:
University Children's Hospital, Zürich, Switzerland
David Nadal
Affiliation:
University Children's Hospital, Zürich, Switzerland
Jody Stähelin
Affiliation:
Children's Hospital, Aarau, Switzerland
Hanspeter Gnehm
Affiliation:
Children's Hospital, Aarau, Switzerland
Klara Posfay-Barbe
Affiliation:
University Children's Hospital, University of Geneva Hospitals, Geneva, Switzerland
Alain Gervaix
Affiliation:
University Children's Hospital, University of Geneva Hospitals, Geneva, Switzerland
Hugo Sax
Affiliation:
Infection Control Program, University of Geneva Hospitals, Geneva, Switzerland
Ulrich Heininger
Affiliation:
University Children's Hospital, Basel, Switzerland
Jan Bonhoeffer
Affiliation:
University Children's Hospital, Basel, Switzerland
Gerhard Eich
Affiliation:
Children's Hospital, St. Gallen, Switzerland
Christian Kind
Affiliation:
Children's Hospital, St. Gallen, Switzerland
Christiane Petignat
Affiliation:
University Children's Hospital, Lausanne, Switzerland
Pietro Scalfaro
Affiliation:
University Children's Hospital, Lausanne, Switzerland
*
Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, CH-3010 Bern, Switzerland
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Abstract

Objective:

To acquire data on pediatric nosocomial infections (NIs), which are associated with substantial morbidity and mortality and for which data are scarce.

Design:

Prevalence survey and evaluation of a new comorbidity index.

Setting:

Seven Swiss pediatric hospitals.

Patients:

Those hospitalized for at least 24 hours in a medical, surgical, intensive care, or intermediate care ward.

Results:

Thirty-five NIs were observed among 520 patients (6.7%; range per hospital, 1.4% to 11.8%). Bacteremia was most frequent (2.5 per 100 patients), followed by urinary tract infection (1.3 per 100 patients) and surgical-site infection (1.1 per 100 patients; 3.2 per 100 patients undergoing surgery). The median duration until the onset of infection was 19 days. Independent risk factors for NI were age between 1 and 12 months, a comorbidity score of 2 or greater, and a urinary catheter. Among surgical patients, an American Society of Anesthesiologists (ASA) score of 2 or greater was associated with any type of NI (P = .03). Enterobacteriaceae were the most frequent cause of NI, followed by coagulase-negative staphylococci; viruses were rarely the cause.

Conclusions:

This national prevalence survey yielded valuable information about the rate and risk factors of pediatric NI. A new comorbidity score showed promising performance. ASA score may be a predictor of NI. The season in which a prevalence survey is conducted must be considered, as this determines whether seasonal viral infections are observed. Periodic prevalence surveys are a simple and cost-effective method for assessing NI and comparing rates among pediatric hospitals.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 9 , September 2004 , pp. 765 - 771
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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