IntroductionThis study aimed to determine the epidemiology of nosocomial infections (NI), in a pediatric intensive care unit (PICU) and to define the risk factors associated with NI. MethodsWe performed a prospective descriptive and analytical monocentric study on the incidence of NI in PICU, between July 2021 and May 2022. Children with NI (cases) were compared with a matched controls without NI. Results: We analyzed 396 patients; 102 had NI. The global incidence of nosocomial infection is 44.7 % (incidence density of 10.6 per 1000 days of hospitalization). The incidence densities of Blood Stream infection, Pneumonia associated with mechanical ventilation, and urinary tract infection were 10/ 1000 days of CVC, 7,2/ 1000 of mechanical ventilation, and 11,1/ 1000 days urinary catheter. The overall microbiological profile of nosocomial infections is dominated by Gram negative bacilli in 78 % followed by Gram positive Cocci in 13 %. The most common agents in sepsis were Klebsiella pneumoniae. In pneumonias Acinetobacter Baumanii was the most common cause, and in UTI the most frequent agents were BGN especially Escherichia Coli (33.3%). The presence of NI was associated with a long period of hospitalization, use of invasive devices (central venous catheter, mechanical ventilation, bladder catheters), and use of antibiotics. ConclusionsThe incidence of NI acquired in this unit was high and was associated with extrinsic and intrinsic factors.