Nosocomial infections represent an important cause of morbidity and mortality for acutely ill children and adolescents.  In 2001, median nosocomial infection rates per 100 patient days were estimated as 8.9 in NICUs and 13.9 in PICUs. (Stover, et al., 2001).  Stockwell estimates that 16% of children develop a nosocomial infection while in the pediatric intensive care unit. 

According to the National Nosocomial Infections Surveillance (NNIS) System Report, the mean rate of central line-associated bloodstream infections among pediatric intensive care units participating in this system was 6.6 per 1000 central line-days, the rate of ventilator associated pneumonia was 2.9 per 100 ventilator days, the rates of urinary catheter associated UTI was 4.0 per 1000 urinary catheter days and the rate of surgical site infections for appendectomy (in adults and children) ranged from 0.67 (for those cases with no risk factors and a laparoscopic procedure) to 4.85 (for patients with significant risk factors) per 100 procedures. 

Further, infections caused by Methicillin- Resistant S. aureus (MRSA) are problematic in neonatal, pediatric and adolescent patients.  Reports from England and Wales (2004) conclude that MRSA bacteraemia is now a serious problem in children, particularly in infants less than 12 months of age.  The CDC reports the rate of MRSA as 13.1 per 1000 discharges for children <14 years (Kuehnert, 2005).  The increasing proportion of MRSA bacteremia in children is a cause for concern for both patients and clinicians.  More data on the risk factors for acquisition and spread of MRSA in neonates, children, and adolescents is required.

References:
CDC National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004.  American Journal of Infection Control 2004. 32:470-85. 

Khairulddin, N, Bishop, L, Lamagni, TL et al. (2004).  Emergence of methicillin resistant Staphylococcus aureus (MRSA) bacteraemia among children in England and Wales, 1990-2001.  (2004). Archives of Disease in Childhood.  89(4): 378-379. 

Kuehnert, MJ, Hill, HA, Kupronis, BA, et al (2005).  Methicillin-resistant-Staphylococcus aureus hospitalization, United States.  Emerging Infectious Diseases.  11(6): 868-872.

Stockwell, JA. (2007). Nosocomial infections in the pediatric intensive care unit:  Affecting the impact on safety and outcome.  Pediatric Critical Care Medicine.  Patient safety and quality in the pediatric intensive care unit.  8 (2).  Suppl: S21-S37.  March 2007.

Stover, BH, Shulman, ST, Bratcher, DF et al.  (2001).  Nosocomial infection rates in US children’s hospitals’ neonatal and pediatric intensive care units.  American Journal of Infection Control.  Jun; 29(3): 152-7.

Join the Pediatric Affinity Group for the following Infections webcasts:

Reducing MRSA Infections
Wednesday, July 25, 2007
Speakers:

• Glenn Billman, M.D., Medical Director of Patient Safety, Children's Hospitals and Clinics of Minnesota
• Craig H. Gilliam, BSMT, (ASCP) CIC, Epidemiologist, Director of Infection Control, Arkansas Children’s Hospital
• Aaron Milstone, M.D., Assistant Professor Pediatric Infectious Diseases, Johns Hopkins University

Reducing Surgical Complications/Surgical Site Infections
Wednesday, August 22, 2007
Speakers:

• Bill Jarvis, M.D., President and CFO, Jason & Jarvis Associates, Adjunct Assistant Professor, Rollins School of Public Health, Emory University, Atlanta, Georgia, Clinical Associate Professor, Division Pediatric Infectious Diseases, Immunology and Epidemiology, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
• Stephen Stayer, M.D., F.A.A.P., Professor of Anesthesiology/Pediatrics, Medical Director-Perioperative Services, Baylor College of Medicine
• Judy Swanson, Director-Operating Rooms, Texas Children’s Hospital
• Danyalle Evans, Quality Improvement Specialist, Texas Children’s Hospital

Prevent Ventilator Associated Pneumonia
Wednesday, October 17, 2007
Speakers:

• Carrie Silver,Performance Improvement Consultant, Children’s Healthcare of Atlanta

Prevent Central Line Infections
Wednesday, October 31, 2007
Speakers:

• Paul Kurtin, M.D., Vice President, Clinical Innovations and Director, Center for Child Health Outcomes, Rady Children’s Hospital and Health Center
• Bill Mason, M.D., Medical Director, Quality Systems Management, Children’s Hospital Los Angeles

Click here to register today!

For a full schedule of the 2007 Pediatric Webcast Series, please click here.