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.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Infection ControlAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Nosocomial infections in pediatric patients: a European, multicenter prospective study.Infect Control Hosp Epidemiol. 2000; 21: 260-263
- Epidemiology of nosocomial infections in pediatric patients.Pediatr Infect Dis J. 1987; 6: 344-351
- Nosocomial infections in the pediatric patients: an update.Am J Infect Control. 1990; 18: 176-193
- Surveillance for nosocomial and central line related infections among pediatric hematology-oncology patients.Infect Control Hosp Epidemiol. 2000; 21: 592-596
- Epidemiologic study of 4684 hospital-acquired infections in pediatric patients.Pediatr Infect Dis J. 1989; 8: 668-675
- National Nosocomial Infections Surveillance (NNIS) report, data summary from October 1986-April 1998, issued June 1998.Am J Infect Control. 1998; 26: 522-533
- CDC definitions for nosocomial infections.Am J Infect Control. 1988; 16: 128-140
- Cancer, principles & practice of oncology.6th edition. Lippincott Williams & Wilkins Publications, Philadelphia (PA)2001
- Cox's regression model for a counting processes: a large sample study.Ann Statistics. 1982; 10: 1100-1120
- Management of fever in patients with cancer and chemotherapy induced neutropenia.N Engl J Med. 1993; 328: 1323-1332
- The child with cancer and infection.J Pediatr. 1991; 119: 679-694
- Down's syndrome and acute lymphoblastic leukaemia: clinical features and response to treatment.Arch Dis Child. 2001; 85: 321-325
- Changing epidemiology of infections in patients with neutropenia and cancer: emphasis on gram positive and resistant bacteria.Clin Infect Dis. 1999; 29: 490-494
- Nosocomial infections in pediatric patients: a prevalence study in Spanish hospitals.Am J Infect Control. 1993; 21: 58-63
- Unique epidemiology of nosocomial infection in a children's hospital.Am J Dis Child. 1984; 138: 131-135
- Nosocomial septicemia in the cancer patients: the influence of central venous access devices, neutropenia and type of malignancy.Med Pediatr Oncol. 1990; 18: 209-216
- Lack of association between neutropenia and the incidence of bacteremia associated with indwelling central venous catheters in febrile pediatric cancer patients.Pediatr Infect Dis J. 1991; 10: 506-510
- Oral versus intravenous empirical antimicrobial therapy for fever in patients with granulocytopenia who are receiving cancer chemotherapy. International Antimicrobial Therapy Cooperative Group of the European Organization for Research and Treatment of cancer.N Engl J Med. 1999; 341: 312-318
- Predicting the risk of bacteremia in children with fever and neutropenia.J Clin Oncol. 1996; 14: 919-924
Article info
Publication history
Barcelona, Spain
Identification
Copyright
© 2004 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Surveillance of nosocomial infections in pediatric cancer patientsAmerican Journal of Infection ControlVol. 33Issue 10
