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Bacterial healthcare-associated infection rates among children admitted to Pediatric Intensive Care Unit of a Tertiary Care Hospital, Egypt

Background Healthcare-associated infections (HAIs) are life-threatening complications especially in pediatric ICU (PICU). Objective This study aimed to calculate the incidence of HAIs and device-associated infections (DAIs), as well as HAIs and DAI incidence density rate in a Alexandria University Children Hospital PICU, Egypt. Patients and methods A prospective cohort study was carried out over a period of 1 year. Personal, clinical, and laboratory data were recorded. HAIs were identified according to Centers for Disease Control and Prevention and National Healthcare Safety Network CDC/National Health Surveillance Network case definitions. Standard microbiological techniques were adopted. Results A total of 195 patients (of 282 admissions) who stayed more than 48 h in PICU were included. Overall, 16 patients developed bacterial HAIs, with a total of 25 episodes. HAIs incidence rate was 12.8/100 PICU admissions and incidence density was 15.6/1000 PICU days. All HAIs detected were DAI. Ventilator-associated pneumonia accounted for 72%, followed by central line (CL)-associated bloodstream infections at 24% and catheter-associated urinary tract infections at 4%.The rates of the DAI per 1000 device days were as follows: ventilator-associated pneumonia 12.4/1000 ventilator days, CL-associated bloodstream infections 4.2/1000 CL days, and catheter-associated urinary tract infections 0.69/1000 urinary catheter days. Gram negative bacteria were the most common isolated pathogens (n=18/25, 72%). All isolates were multidrug-resistant organisms. Conclusion and recommendations HAIs and DAI incidence rates in the current study were close to those of developed countries and lower than those of developing countries. Presence of an invasive device has a high risk for acquiring HAIs, resulting in higher mortality. The key to prevent HAIs is continuous education of infection prevention and control practices including an adoption of a surveillance program.