• The Journal of pediatrics · Apr 2002

    Multicenter Study Comparative Study

    A national point-prevalence survey of pediatric intensive care unit-acquired infections in the United States.

    • Lisa A Grohskopf, Ronda L Sinkowitz-Cochran, Denise O Garrett, Annette H Sohn, Gail L Levine, Jane D Siegel, Beth H Stover, William R Jarvis, and Pediatric Prevention Network.
    • Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Atlanta, Georgia, USA.
    • J. Pediatr. 2002 Apr 1;140(4):432-8.

    ObjectiveTo determine the prevalence of intensive care unit-acquired infections, a major cause of morbidity in pediatric intensive care unit (PICU) patients.MethodsPediatric Prevention Network hospitals (n = 31) participated in a point-prevalence survey on August 4, 1999. Data collected for all PICU inpatients included demographics, infections, therapeutic interventions, and outcomes.ResultsThere were 512 patients in 35 PICUs. The median age was 2.2 years (range, <1 day-35.4 years). Seventy-five PICU-acquired infections occurred among 61 (11.9%) patients. The most frequently reported sites were bloodstream (31 [41.3%]), lower respiratory tract (17 [22.7%]), urinary tract (10 [13.3%]), or skin/soft tissue (6 [8.0%]). The most frequent pathogens were coagulase-negative staphylococci (in 16 [21.3%] infections), Candida spp. (13 [17.3%]), enterococci (10 [13.3%]), Staphylococcus aureus (9 [12.0%]), or Pseudomonas aeruginosa (8 [10.7%]). Age-adjusted risk factors for infection included central intravenous catheters (relative risk [RR], 4.1; 95% confidence intervals [CI], 2.4-7.1), arterial catheters (RR, 2.4; 95% CI, 1.5-3.9), total parenteral nutrition (RR, 5.5; 95% CI, 3.6-8.5), or mechanical ventilation (RR, 3.9; 95% CI, 2.2-6.8). Infection was associated with higher age-adjusted risk of death within 4 weeks of the survey (RR, 3.4; 95% CI, 1.7-6.5).ConclusionsThis national multicenter study documented the high prevalence of PICU-acquired infections. Preventing these infections should be a national priority.

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