Hospital Epidemiology and Infection Control for Children: Report From the Society for Healthcare Epidemiology of America Pediatric Leadership Council.

Abstract

Given the evolving epidemiology of healthcare-associated infections (HAIs) in children and the intense national focus by clinicians and regulators on infection prevention efforts, the goal of this commentary is to describe the activities and achievements of the Pediatric Leadership Council (PLC) of the Society for Healthcare Epidemiology of America (SHEA) and to highlight potential opportunities within the field of pediatric hospital epidemiology and infection prevention. Although preventing infections has been recognized as a critical component of healthcare for over 150 years [1, 2], the field of hospital epidemiology and infection control as a focused area of practice is relatively young. The Hospital Infections Unit was established at the Centers for Disease Control and Prevention (CDC) in 1966 [3] in the context of the emergence of hospitalacquired Staphylococcus aureus infections. The landmark SENIC (Study on the Efficacy of Nosocomial Infection Control) Project in the 1970s established that implementing effective infection prevention and control programs in hospitals could reduce HAI rates by up to 32% [4]. Over the last 15 years, much attention has been focused on HAI as a continuing major threat to the safety of patients in a variety of healthcare settings [5]. Hospitals and healthcare systems have worked hard to institute evidence-based practices to prevent infections. This work has occurred in children’s hospitals in parallel to the efforts occurring in hospitals that treat adult patients. Differences between adult and pediatric populations require that typical approaches for infection prevention be tailored to meet the needs of children. Issues such as age-related differences in development, immunity, device utilization, and availability of specific technologies, along with the ultimate goal of family-centered care, all contribute to and impact the risk of HAI for children [6]. At a national level, pediatric hospital epidemiologists have advocated for consideration of these special approaches as infection prevention policies are developed (eg, through the inclusion of a pediatric infectious diseases [ID] physician on the Healthcare Infection Control Practices Advisory Committee [HICPAC] since its establishment in 1991) and have conducted original research to generate knowledge and test the efficacy of preventive interventions in pediatric populations. In recognition of the need for better data on pediatric HAI, in 1997 the CDC and the National Association of Children’s Hospitals and Related Institutions established the Pediatric Prevention Network, a multinational collaborative of 77 children’s hospitals whose goals included assessing the prevalence of HAI and antimicrobial resistance and ultimately improving pediatric outcomes [7]. SHEA is a professional society founded in 1980, and its mission is to prevent and control healthcare-associated infections and advance the field of healthcare epidemiology through research, education, and translation of knowledge into effective policy and practice. In 1995, a pediatric special interest group (PSIG) within SHEA was created as an informal gathering of professionals who were interested in the unique challenges of infection prevention for children. Over the next 15 years, PSIG members worked to provide pediatric expertise in healthcare epidemiology and represent the Invited Commentary