Comparative Evaluation of Health Care-Related Infections in Pediatric and Newborn Intensive Care Units in A University Hospital: The Seven-Year Retrospective Study

Özaslan, Zeynep; Çelebi, Solmaz; Köksal, Fatma; Özkan, Hilal; Ocakoğlu, Gökhan; Yeşil, Edanur; Özer, Arife; Turan, Cansu; Bülbül, Beyhan; Hacımustafaoğlu, Mustafa

doi:10.4274/jcp.2021.0029

Cited by 2 publications

(5 citation statements)

References 22 publications

(23 reference statements)

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“…Similar to other studies, in the present study, the mean age of the patients cared for in the aICU was (7.4 ± 5.4) years (10)(11)(12). The length of stay in the pICU was generally between 2 and 9.7 days in previous studies; it was similarly 6.6 ± 14.2 days in the present study (13)(14)(15). The length of hospital stay was found to vary according to the inpatient profile, with 11.8 ± 17.7 days in the present study, which was different to other studies (15,16).…”

Section: Discussionsupporting

confidence: 89%

“…The length of stay in the pICU was generally between 2 and 9.7 days in previous studies; it was similarly 6.6 ± 14.2 days in the present study (13)(14)(15). The length of hospital stay was found to vary according to the inpatient profile, with 11.8 ± 17.7 days in the present study, which was different to other studies (15,16). It is thought that the longer ICU and hospital stays recorded in the present study could be attributable to chronic comorbidities in 76.2% of the patients and the lack of a sufficient number of palliative care units and rehabilitation centres.…”

Section: Discussionsupporting

confidence: 80%

“…It has also been reported that nosocomial infections prolong hospital stay and increase mortality in the paediatric age group (13,15). The nosocomial infection rate was 12.8% in our study.…”

Section: Discussionsupporting

confidence: 74%

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Evaluation of Critically Ill Paediatric Patients in the Adult ICU

Sevdi

Müslümanoğlu

2022

Iran J Pediatr

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Background: Critically ill paediatric patient (CIPP) care may be required in the adult intensive care unit (aICU) of hospitals in cases where there is no paediatric intensive care unit (pICU) or when the pICU bed capacity is insufficient. Objectives: This is a retrospective evaluation of CIPPs who were accommodated in aICUs over the last 10 years to determine the type of hospital admission, indications for hospitalization, presence of comorbidities, treatments, causes of mortality, and effects of these parameters on mortality. Methods: We retrospectively analysed the medical records of 600 patients aged 28 days to 17 years who had been cared for at least 24 hours in aICUs between 2011 and 2021. Results: The average age of the CIPPs ((252 female (42%), 348 male (58%)) was 6 (7.4 ± 5.4) years. The mortality rate was 14.7%, and trauma (31.8%) was the most common cause of mortality, followed by respiratory diseases and septic shock. The independent risk factors found to be associated with mortality were as follows: Lower age, admission to ICUs from emergency departments of hospitals, higher Pediatric Risk of Mortality III and Pediatric Logistic Organ Dysfunction II scores, duration of hospital stay and of mechanical ventilation, vasopressor/inotropic agent requirement in the first 24 hours, higher total transfusion requirement, presence of nosocomial infection, thrombocytopenia, and lower haemoglobin level. Conclusions: It is important to achieve the best results and better outcomes for CIPPs in pICUs. However, a significant proportion of CIPPs currently hospitalized in aICUs are admitted with trauma. A close follow-up of mortality scores and clinical parameters in the early period of CIPP care in the aICU is critical as some mortality risk factors are preventable.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 80%

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Evaluation of Critically Ill Paediatric Patients in the Adult ICU

Sevdi

Müslümanoğlu

2022

Iran J Pediatr

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“…11,12 In Türkiye, studies have reported HAI rates of 3.2 to 42.3%, and HAI incidence densities of 3.1 to 21.3/1,000 patient days in NICUs. 2,13 In our study, the HAIs rate was 3.4% and the incidence density was 2.68/1,000 patient days, rather lower than in other Turkish studies.…”

Section: Discussioncontrasting

confidence: 74%

“…Widely varying rates of HAI in NICUs have been reported globally (7.3-57.7%) and in Türkiye (3.2-42.3%). 1,2 The most common infections in NICUs are bloodstream infections (BSIs), pneumonia, and urinary tract infections (UTIs). Among the risk factors for HAIs are prematurity, low birth weight, mechanical ventilation, central venous catheter use, inappropriate use of broad-spectrum antibiotics, and long-term hospitalization.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology, Risk Factors, and Outcomes of Health Care-Associated Infections in the Neonatal Intensive Care Unit: 6-Year Surveillance at a University Hospital in Türkiye

Erayman,

Bulut,

Kandemir

et al. 2024

J Pediatr Infect Dis

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Objective Health care-associated infections (HAIs) are important causes of morbidity and mortality in neonatal intensive care units (NICUs). This study aimed to evaluate the frequency of HAIs and related factors in the NICU. Methods HAIs detected and monitored by daily active surveillance by the Infection Control Team at Necmettin Erbakan University Faculty of Medicine NICU between January 1, 2017 and December 31, 2022 were evaluated retrospectively. There were a total of 43 incubators in our hospital's NICU (19 secondary level units and 24 tertiary level). Between 2017 and 2022, there was an average of 982 admissions to the NICU per year. Results A total of 5,895 newborns and 74,726 patient days were monitored in the study. The average HAIs rate for all study years was 3.4% and the incidence density was 2.68 per thousand patient days. The highest HAI rate was in newborns with birth weights < 750 g. A total of 201 HAIs were detected in 172 patients. Bloodstream infection (BSI) was the most frequent HAI. The most frequent pathogens were Klebsiella spp. (44.8%), methicillin-resistant coagulase-negative staphylococci (CoNS) (24.4%), and Acinetobacter spp. (11.6%). Note that 88.5% of Enterobacterales were extended-spectrum beta-lactamase producers, and 26% of Klebsiella spp. were carbapenem-resistant. No colistin resistance was detected in Pseudomonas aeruginosa and Acinetobacter spp. Methicillin resistance was detected in 86.5% of CoNS and 50% of Staphylococcus aureus. The vancomycin resistance rate in Enterococcus spp. was 40%. Note that 16.7% of Candida spp. were fluconazole-resistant; no resistance to caspofungin was found. The most common risk factors for development of HAI were prematurity, umbilical catheter use, total parenteral nutrition, and mechanical ventilation. The mortality rate in patients with HAIs was 20.9%. Conclusion HAIs, including those caused by multidrug-resistant Gram-negative bacteria, are an important problem in our hospital, and also globally. Active surveillance should be continued, and changes over the years evaluated. Infection control programs should be executed by determining the risk and mortality factors attributed to infection and their implementation should be closely monitored. These practices will increase success in the fight against HAIs and antimicrobial resistance.

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Comparative Evaluation of Health Care-Related Infections in Pediatric and Newborn Intensive Care Units in A University Hospital: The Seven-Year Retrospective Study

Cited by 2 publications

References 22 publications

Evaluation of Critically Ill Paediatric Patients in the Adult ICU

Evaluation of Critically Ill Paediatric Patients in the Adult ICU

Epidemiology, Risk Factors, and Outcomes of Health Care-Associated Infections in the Neonatal Intensive Care Unit: 6-Year Surveillance at a University Hospital in Türkiye

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