Summary
Background
Few studies provide rates of nosocomial bloodstream infections (BSIs) in mixed neonatal
and paediatric intensive care units (PICUs).
Aim
To determine the rate, pathogens and outcome of BSIs in an Estonian PICU.
Methods
Data were collected prospectively from 1st January 2004 to 31st December 2008 in the
PICU of Tartu University Hospital. The definition criteria of the US Centers for Disease
Control and Prevention were applied for the diagnosis of laboratory-confirmed BSI.
Findings
A total of 126 episodes of BSI were identified in 89 patients (74 neonates, eight
infants, seven patients aged >1 year). Among neonates 42 (57%) had birth weight <1000g. The overall incidence of BSI was 9.2 per 100 admissions, incidence density 12.8
per 1000 patient-days. Primary BSI was diagnosed in 92 episodes. Central line (CL)-associated
BSI incidence density for neonates was 8.6 per 1000 CL-days with the highest incidence
(27.4) among neonates with extremely low birth weight. The most common pathogens were
coagulase-negative staphylococci (43%) and Serratia marcescens (14%). Resistance to meticillin was detected in four out of seven S. aureus isolates (all were part of an outbreak) and 23% of Enterobacteriaceae were extended
spectrum beta-lactamase (ESBL)-producing strains. Overall case-fatality rate was 10%.
Conclusion
We observed higher rates of BSIs in our mixed PICU than reported previously. High
levels of antimicrobial resistance were detected. Future research should focus on
the effects of infection control measures to prevent outbreaks and to decrease incidence
of CL-associated BSI.
Keywords
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Article info
Publication history
Published online: December 02, 2013
Accepted:
November 4,
2013
Received:
November 14,
2012
Identification
Copyright
© 2013 The Healthcare Infection Society. Published by Elsevier Inc. All rights reserved.
