#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Aktívna surveillance nemocničných infekcií na pediatrickej jednotke intenzívnej starostlivosti


Authors: M. Fulová;  M. Kotrbancová;  J. Perželová;  A. Bražinová
Authors‘ workplace: Comenius University in Bratislava, Faculty of Medicine, Institute of Epidemiology, Bratislava, Slovak Republic
Published in: Epidemiol. Mikrobiol. Imunol. 73, 2024, č. 4, s. 192-197
Category: Original Papers
doi: https://doi.org/10.61568/emi/11-6390/20241024/138874

Overview

Cieľ: Cieľom práce bolo opísať a analyzovať výskyt, etiológiu a rizikové faktory nemocničných nákaz na pediatrickej jednotke intenzívnej starostlivosti (JIS).

Úvod: Pacienti hospitalizovaní na JIS patria medzi vysokorizikových z hľadiska vzniku nemocničných nákaz (NN) kvôli závažnému až kritickému zdravotnému stavu a potreby invazívnych diagnostických a terapeutických zásahov.

Metódy: Do štúdie sme zaradili pacientov hospitalizovaných na detskej JIS na dlhšie ako 2 dni v priebehu šiestich mesiacov (spolu 267 pacientov, 1570 pacientskych dní). Pre zber údajov o výskyte NN sme použili štandardný protokol Európskeho centra pre prevenciu a kontrolu chorôb HAI-Net ICU v2.2.

Výsledky: Infekcie v súvislosti s hospitalizáciou na JIS sme zistili u 17 (6,4 %) pacientov (10,8 infekcií/1000 pacientskych dní). Najčastejšie išlo o infekcie krvného riečiska v súvislosti so zavedeným katétrom (33 %, 7,6/1000 katétrových dní) a pneumóniu v súvislosti s intubáciou (25 %, 10,9/1000 dní intubácie). V etiológii dominovali gramnegatívne baktérie (Pseudomonas aeruginosa, Kleb­ siella spp.). Vyššie riziko vzniku NN mali pacienti s centrálnym venóznym katétrom (OR: 14,5; 95% CI 3,2–65,1), intubovaní (OR: 14,4; 95% CI 4,4–46,2), s Pediatrickým indexom mortality vyšším ako 10 (OR: 17; 95% CI 2,7–111,5) a s predchádzajúcou bakteriálnou a/ alebo mykotickou kolonizáciou (OR: 30,6; 95% CI 9,2–101,3).

Záver: Aktívne sledovanie výskytu nemocničných nákaz poskytuje presný obraz o situácii na úrovni vybraných oddelení nemocnice a patrí medzi prvé kroky k cielenej prevencii.

Klíčová slova:

nemocničné nákazy – aktívna surveillance – pediatrická JIS


Sources
  1. Allegranzi B, Nejad SB, Castillejos GG, et al. Report on the Burden of Endemic Health Care-Associated Infection Worldwide. A systematic review of the literature. World Health Organization. Geneva: WHO Document Production Services; 2011. Available at: https://apps.who.int/iris/bitstream/handle/10665/80135/9789241501507_eng.pdf (accessed on 24 August 2023).
  2. Suetens C, Kärki T, Plachouras D. Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals. Surveillance Report. European Centre for Disease Prevention and Control. Stockholm: ECDC; 2024. Available at: https://www.ecdc.europa.eu/sites/default/ files/documents/healthcare-associated-point-prevalence-survey-acute-care-hospitals-2022-2023.pdf (accessed on 24 June 2024).
  3. Zingg W, Hopkins S, Gayet-Ageron A, et al. Health-care-associated infections in neonates, children, and adolescents: an analysis of paediatric data from the European Centre for Disease Prevention and Control point-prevalence survey. Lancet Infect Dis, 2017;17(4):381–389. doi: 10.1016/S1473-3099(16)30517-5.
  4. European Centre for Disease Prevention and Control. Surveillance of healthcare-associated infections and prevention indicators in European intensive care units. HAI-Net ICU protocol, version 2.2. Stockholm: ECDC; 2017.
  5. Pediatric Index of Mortality, revised version. Available at: https://www.openpediatrics.org/assets/calculator/pediatric-in- dex-mortality-2 (accessed on 16 December 2019).
  6. European Commission. Commission Implementing Decision (EU) 2018/945 of 22 June 2018 on the communicable diseases and related special health issues to be covered by epidemiological surveillance as well as relevant case definitions. Official Journal of the European Union, 2018; L 170:1–74.
  7. Fitzpatrick F, Doherty A, Lacey G. Using Artificial Intelligence in Infection Prevention. Curr Treat Options Infect Dis, 2020;12(2):135–144. doi: 10.1007/s40506-020-00216-7.
  8. Briassoulis P, Briassoulis G, Christakou E, et al. Active Surveillance of Healthcare-associated Infections in Pediatric Intensive Care Units: Multicenter ECDC HAI-net ICU Protocol (v2.2) Implementation, Antimicrobial Resistance and Challenges. Pediatr Infect Dis J, 2021;40(3):231–237. doi: 10.1097/INF.0000000000002960.
  9. Folgori L, Bernaschi P, Piga S, et al. Healthcare-Associated Infections in Pediatric and Neonatal Intensive Care Units: Impact of Underlying Risk Factors and Antimicrobial Resistance on 30-Day Case-Fatality in Italy and Brazil. Infect Control Hosp Epidemiol, 2016;37(11):1302–1309. doi: 10.1017/ice.2016.185.
  10. Fresán-Ruiz E, Pons-Tomás G, de Carlos-Vicente JC, et al. Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs. Children (Basel), 2022;9(11):1669. doi: 10.3390/children9111669.
  11. Urrea M, Pons M, Serra M, et al. Prospective incidence study of nosocomial infections in a pediatric intensive care unit. Pediatr Infect Dis J, 2003;22(6):490–494. doi: 10.1097/01. inf.0000069758.00079.d3.
  12. Morillo-García Á, Aldana-Espinal JM, Olry de Labry-Lima A, et al. Hospital costs associated with nosocomial infections in a pediatric intensive care unit. Gac Sanit, 2015;29(4):282–287. doi: 10.1016/j.gaceta.2015.02.008.
  13. Jordan Garcia I, Esteban Torné E, Bustinza Arriortua A, et al. Trends in nosocomial infections and multidrug-resistant microorganisms in Spanish pediatric intensive care units. En­ ferm Infecc Microbiol Clin, 2016;34(5):286–292. doi: 10.1016/j. eimc.2015.07.010.
  14. Sati H, Gigante V, Cameron AM, et al. WHO Bacterial Priority Pathogens List, 2024: Bacterial pathogens of public health importance to guide research, development and strategies to prevent and control antimicrobial resistance. Geneva: WHO; 2024. Available at: https://www.who.int/publications/i/ item/9789240093461 (accessed on 24 June 2024).
  15. Hatachi T, Tachibana K, Takeuchi M. Incidences and influences of device-associated healthcare-associated infections in a pediatric intensive care unit in Japan: A retrospective surveillance study. J Intensive Care, 2015;3:44. doi: 10.1186/s40560-0150111-6.
  16. Ling ML, Apisarnthanarak A, Jaggi N, et al. APSIC guide for prevention of Central Line Associated Bloodstream Infections (CLABSI). Antimicrob Resist Infect Control, 2016;5:16. doi: 10.1186/s13756-016-0116-5.
  17. Muscedere J, Dodek P, Keenan S, et al. Comprehensive evidence-based clinical practice guidelines for ventilator-associated pneumonia: prevention. J Crit Care, 2008;23(1):126–137. doi: 10.1016/j.jcrc.2007.11.014.
  18. Lee L, Conaway M, Spaeder MC, et al. Incidence of colonization of central venous catheter and arterial catheter tips in a paediatric intensive care unit. J Hosp Infect, 2017;96(3):229–231. doi: 10.1016/j.jhin.2017.04.021.

Conflict of interest
The authors declare no conflict of interest.

Funding: This research received no external funding. The APC was funded by project VEGA 1/0761/22 Scientific Grant Agency of the Ministry of Education, science, research and sport of the Slovak Republic and the Slovak Academy of Sciences.

Acknowledgments: We acknowledge the hospital epidemiologist Jana Boledovičová, MSc. for data access.

Do redakce došlo dne 2. 5. 2024.

Adresa pro korespondenci:
MUDr. Mgr. Miriam Fulová, PhD.
Ústav epidemiologie Lékařská fakulta Univerzity Komenského v Bratislavě
Moskovská 3
811 08 Bratislava Slovenská republika
e­mail:
miriam.fulova@fmed.uniba.sk

Labels
Hygiene and epidemiology Medical virology Clinical microbiology
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#