Nosocomial bloodstream infections in pediatric patients in United States hospitals: epidemiology, clinical features and susceptibilities

Wisplinghoff, Hilmar; Seifert, Harald; Tallent, Sandra M.; Bischoff, Tammy; Wenzel, Richard P.; Edmond, Michael B.

doi:10.1097/01.inf.0000078159.53132.40

Cited by 294 publications

(221 citation statements)

References 16 publications

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“…This finding was in line with the report from the US [54], while Gram-negative pathogens predominated in the other two studies [53,245]. Neither methicillin resistance in S. aureus isolates nor vancomycin resistance in E. faecium isolates was detected during the study.…”

Section: Microbiological Aspectssupporting

confidence: 81%

“…Neither methicillin resistance in S. aureus isolates nor vancomycin resistance in E. faecium isolates was detected during the study. The finding differed from the corresponding rates of the US study (16% and 11%, respectively) [54] …”

Section: Microbiological Aspectscontrasting

confidence: 56%

“…Preoperative stay (OR = 2.7; CI95%, 1.1-6.6) and ASA (OR = 2.4; CI95%, 1.1-5.3) were significant risk factors in one model, but in the other model, none of the covariables was significant by itself. Hospital-wide studies on pediatric nosocomial BSIs are scarce; only three such reports were available, a multi-center report from the US [54], one from an Israeli tertiary care center [53], and one from a Mexican general hospital [245]. We found a BSI rate of 5.7 infections per 1,000 discharges, whereas the overall rates of other studies ranged from 5.3 to 29.4 infections per 1,000 discharges.…”

Section: Risk Factors For Surgical Site Infectionsmentioning

confidence: 40%

“…The majority of the severe HAIs (e.g., BSIs) associated with increased mortality occur, however, in patients with severe underlying conditions. Reported mortality rates associated with BSIs have been substantially higher: 9%-14% in pediatric patients in general [53,54], 18%-20% in PICUs [55,56], and 8%-18% in NICUs [10,57].…”

Section: Importance To Public Health M O R B I D I T Ymentioning

confidence: 99%

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314 Healthcare-Associated Infections in Pediatrics

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Helsinki 2008 P u b l i c a t i o n s o f t h e N a t i o n a l P u b l i c H e a l t h I n s t i t u t e K T L A 1 1 / 2 0 0 8 Dr. Alexander Langmuir, 1963 Emmi Sarvikivi, Healthcare-associated infections in pediatrics Publications of the National Public Health Institute, A11/2008, 93 Pages ISBN 978-951-740-803-5; 978-951-740-804-2 (pdf-version) ISSN 0359-3584; 1458-6290 (pdf-version) http://www.ktl.fi/portal/4043 ABSTRACT Background and aims. Healthcare-associated infections (HAIs) are known to increase the risk for patient morbidity and mortality in different healthcare settings and thereby to cause additional costs. HAIs typically affect patients with severe underlying conditions, such as patients treated in intensive care units, or patients who have undergone medical procedures, e.g., surgery. HAIs are prevalent also among pediatric patients, but the distribution of the types of infection and the causative agents differ from those detected in adults. The aim of this study was to obtain information on pediatric HAIs in Finland through an assessment of the surveillance of bloodstream infections (BSIs), through two outbreak investigations in a neonatal intensive care unit (NICU), and through a study of postoperative HAIs after open-heart surgery.Methods. The Hospital for Children and Adolescents of the Helsinki University Central Hospital has participated in the BSI surveillance of the Finnish Hospital Infection Program since 1999. These data were utilized in all studies. The epidemiological features of pediatric BSIs were assessed. For the outbreak investigations, case definitions were set and data collected from microbiological and clinical records. The antimicrobial susceptibilities of the Serratia marcescens and the Candida parapsilosis isolates were determined. The S. marcescens isolates were genotyped with pulsed-field gel electrophoresis and the C. parapsilosis blood culture isolates (obtained between the years 1990 and 2002) with Southern blot hybridization by use of a DNA fingerprinting probe. Patient charts were reviewed for the case-control and cohort studies during the outbreak investigations, as well as for those patients who acquired surgical site infections (SSIs) after having undergone open-heart surgery. Also a prospective postdischarge study was conducted to detect postoperative HAIs after open-heart surgery.Results. During 1999During -2006, the overall annual BSI rate was 1.6/1,000 patient-days (range by year, 1.2-2.1). High rates (average, 4.9 and 3.2 BSIs/1,000 patient-days) were detected in hematology and neonatology units. Coagulase-negative staphylococci were the most common pathogens both hospital-wide and in each patient group. The overall mortality was 5%. The genotyping of the 15 S. marcescens isolates revealed three independent clusters. All of the 26 C. parapsilosis isolates studied proved to be indistinguishable. No common source was identified for either of the outbreaks, but the NICU was overcrowded during the S. marcescens clusters. In both investigations, low birth we...

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Section: Microbiological Aspectssupporting

confidence: 81%

Section: Microbiological Aspectscontrasting

confidence: 56%

Section: Risk Factors For Surgical Site Infectionsmentioning

confidence: 40%

Section: Importance To Public Health M O R B I D I T Ymentioning

confidence: 99%

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314 Healthcare-Associated Infections in Pediatrics

SpringerReference

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“…Enterobacteriaceae found in livestock and on retail meat include the opportunistic pathogens Escherichia coli and Klebsiella (Davis and Price, 2016;Davis et al, 2015;Nordstrom et al, 2013), which are the most common causes of urinary tract infections and among the most common causes of bloodstream infections in patients (Davis and Price, 2016;Diekema et al, 2003;Laupland and Church, 2014;Laupland et al, 2007;Russo and Johnson, 2003;Wisplinghoff et al, 2004). Staphylococcus aureus, the most common cause of skin infections and second most common cause of bloodstream infections in patients (Brook and Frazier, 1995;Carratala et al, 2003;Diekema et al, 2001;Sigurdsson and Gudmundsson, 1989;Wisplinghoff et al, 2003a;Wisplinghoff et al, 2003b;Wisplinghoff et al, 2004), is also found on the skin of livestock and on retail meat (Smith, 2015;Smith and Wardyn, 2015). These organisms move easily between farm animals and humans and also from humans to other humans in the community and in health care settings.…”

Section: The Current State Of Antibiotic Resistancementioning

confidence: 99%