Frequency of Nosocomial Infections in Pediatric Intensive Care Unit at King Abdulaziz Medical City, Riyadh, Saudi Arabia

Abstract

Background: Nosocomial infections in PICU vary from 6–26%. Causative pathogens isolated depend upon patient disease, exposure to invasive and non-invasive procedures, and body-system affected. Objectives: To determine frequency of nosocomial infections, organisms involved, sites affected and clinical outcome in pediatric patients. Methods: It is a retrospective cross-sectional study on pediatric patients who acquired infections after 48 hours of admission in PICU at King Abdulaziz Medical City during 2012. Data was collected from medical, laboratory records. Results: 22 (3%) patients acquired nosocomial infections in 684 admissions during year 2012, out of which 12 were female and 10 were male patients. The common incidence was found in first year of age (10 patients). There were a total of 57 events in these patients; respiratory infections were the commonest (24) followed by urinary infections (19). Most common organism involved was Klebsiella (16) followed by Candida (13). Most common pathogens isolated from respiratory infections were Klebsiella pneumoniae (6) and Pseudomonas aeruginosa (5), while Klebsiella (6) and Candida (5) were found in urinary tract infections. The common organisms causing septicemia included Candida (4) and Klebsiella pneumoniae (4). In initial 10 days of admission at PICU, 10 patients acquired the infection (median 14 days). Acquisition of nosocomial infections prolonged hospitalization (median 49.5 days). Conclusion: Nosocomial infections were caused by Klebsiella and Candida. These pathogens mainly caused respiratory, urinary and hematogenous infections, respectively. They have prolonged hospitalization. There is an extensive need for further studies to identify risk factors and review empiric management.