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Nosocomial infections among pediatric hematology/oncology patients: Results of a prospective incidence study

  • Mireya Urrea
    Correspondence
    Reprint requests: Mireya Urrea Ayala, MD, Quality Service-Infection Hospital Program, Hospital Sant Joan de Déu Pg, Sant Joan de Déu, 2, 08950 Esplugues, Barcelona, Spain.
    Affiliations
    From Quality Service-Infection Hospital Programa; Department of Pediatric Hematology and Oncologyb; Biostatistic Unit-Universitat Autònoma de Barcelonac; and Service of Pediatric,d Hospital Sant Joan de Déu, Barcelona, Spain
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  • Susana Rives
    Affiliations
    From Quality Service-Infection Hospital Programa; Department of Pediatric Hematology and Oncologyb; Biostatistic Unit-Universitat Autònoma de Barcelonac; and Service of Pediatric,d Hospital Sant Joan de Déu, Barcelona, Spain
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  • Ofelia Cruz
    Affiliations
    From Quality Service-Infection Hospital Programa; Department of Pediatric Hematology and Oncologyb; Biostatistic Unit-Universitat Autònoma de Barcelonac; and Service of Pediatric,d Hospital Sant Joan de Déu, Barcelona, Spain
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  • Albert Navarro
    Affiliations
    From Quality Service-Infection Hospital Programa; Department of Pediatric Hematology and Oncologyb; Biostatistic Unit-Universitat Autònoma de Barcelonac; and Service of Pediatric,d Hospital Sant Joan de Déu, Barcelona, Spain
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  • Juan José Garcı́a
    Affiliations
    From Quality Service-Infection Hospital Programa; Department of Pediatric Hematology and Oncologyb; Biostatistic Unit-Universitat Autònoma de Barcelonac; and Service of Pediatric,d Hospital Sant Joan de Déu, Barcelona, Spain
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  • Jesús Estella
    Affiliations
    From Quality Service-Infection Hospital Programa; Department of Pediatric Hematology and Oncologyb; Biostatistic Unit-Universitat Autònoma de Barcelonac; and Service of Pediatric,d Hospital Sant Joan de Déu, Barcelona, Spain
    Search for articles by this author

      Abstract

      Background

      Nosocomial infections (NI) are an important clinical complication in adult and children patients at the different hospital wards. NI cause considerable morbidity and mortality and are associated with prolonged hospital stay and increased health care costs.

      Objective

      The objective of this study was to describe the incidence of NI in pediatric patients with neoplastic disease as a first step toward improving infection control policies.

      Methods

      A prospective surveillance study from March through May 2001 was performed in the pediatric hematology/oncology unit at the University Hospital in Barcelona. The Centers for Disease Control and Prevention criteria were used as standard definition for NI. NI rates were calculated as a density incidence rate (per 100 patient-days).

      Results

      Fifty-one patients were admitted during the study period. Twelve patients had a total of 18 NI. The incidence of NI was 1.77 per 100 patient-days. Patients with acute lymphoblastic leukemia had the highest NI rate (2.71 per 100 patient-days). The most frequent episodes of NI were bacteremia (55.5%) and fever of unknown origin (16.6%). The most frequently isolated microorganisms were gram-positive bacteria (78.6%). Coagulase-negative Staphylococci were the most common isolates in bacteremias (70%). The extrinsic risk factors related with the highest incidence rates of NI per 100 patient-days were central venous catheterization (1.7 infections) and parenteral nutrition (3.2 infections).

      Conclusions

      Extrinsic risk factors associated with NI have been identified in this high-risk population. These findings suggest the need to evaluate the infection control measures to reduce the morbidity and mortality in a hematology/oncology unit.
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