Abstract
Health care-associated infections (HCAIs) can cause an increase in morbidity, mortality and costs, especially in developing countries. As information on the epidemiology of HCAIs in pediatric patientsinTurkey is limited, we decided to study the annual incidence and antibiotic resistance patterns in our pediatric ward at Marmara University Hospital. All hospitalized patients in the pediatric ward were assessed with regard to HCAIs between January 1, 2008 and December 31, 2010. Data was prospectively collected according to standard protocols of the National Nosocomial Infections Surveillance System (NosoLINE). A total of 16.5% of all hospitalized patients developed HCAIs in the three years studied. The most frequent HCAIs were urinary tract infections (UTI) (29.3%), bloodstream infections (27%) and pneumonias (21%). While the most frequent agent isolatedfrom UTI was Escherichia coli (26%), the most common agent in blood stream infections was Staphylococcus epidermidis (30.4%). Vancomycin resistance was found in 73.3% of all Enterococcus faecium strains. Extended-spectrum β-lactamase was detected in 58.3% of Klebsiella pneumoniae and E. coli isolates. Continual HCAI surveillance is important to determineits rate. Knowledge of the HCAI incidence can influence people's use of broad-spectrum antibiotics and encourage antibiotic rotation. Moreover, the knowledge of HCAI incidence may support the infection control programmes, including education and isolation methods which ultimately may help to reducethe rate of the HCAIs.
Highlights
Health care-associated infections (HCAIs) can cause an increase in morbidity, mortality and costs, especially in developing countries
The HCAI are tabulated by year and infection site in Table 1.The most frequent HCAIs were urinary tract infection (UTI) (29.3%), bacteremia (27%) and pneumonia (21%)
The most common agents isolated from HCAIs were Staphylococcus epidermidis (10%), Escherichia coli (8.7%), Enterococcus faecium (7.8%) and Klebsiella.pneumoniae (6.7%).The most frequent agents isolated from urinary tract infections (UTI) were E. coli (26%), K. pneumoniae (16%), Candida albicans (10.8%) and E. faecium (10.8%) (Table 3)
Summary
Health care-associated infections (HCAIs) can cause an increase in morbidity, mortality and costs, especially in developing countries. The knowledge of HCAI incidence may support the infection control programmes, including education and isolation methods which may help to reducethe rate of the HCAIs. Health care-associated infections (HCAIs) are important complications in both adults and children that may lead to increased morbidity and mortality, prolonged hospital stay and increased costs [1]. In the United States 5%-10% ofadult patients hospitalized suffer HCAI while the rate is 1.5%-4% for children of ten years of age, and 7%-9% for infants younger than 1 year of age [4] This relationship between increased infection rate and younger age disappears in pediatric and neonatal intensive care units as the rate of HCAI reported for both is highdue to the increased severity of diseases and the need for more invasive procedures [5]. The incidence of HCAI has been reported to be higher than in developed nations because of the high number of patients, limited number of staff, and insufficient compliance with infection control measures [6,7]
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