Health Care-Associated Infections Among Critically III Children in the US, 2007-2012

被引:60
作者
Patrick, Stephen W. [1 ,2 ,3 ]
Kawai, Alison Tse [4 ,5 ]
Kleinman, Ken [4 ,5 ]
Jin, Robert [4 ,5 ]
Vaz, Louise [4 ,5 ,6 ,7 ]
Gay, Charlene [4 ,5 ]
Kassler, William [8 ]
Goldmann, Don [9 ]
Lee, Grace M. [4 ,5 ,6 ,7 ]
机构
[1] Vanderbilt Univ, Dept Pediat, Nashville, TN USA
[2] Vanderbilt Univ, Mildred Stahlman Div Neonatol, Nashville, TN 37235 USA
[3] Vanderbilt Ctr Hlth Serv Res, Nashville, TN USA
[4] Ctr Child Hlth Care Studies, Harvard Pilgrim Hlth Care Inst, Dept Populat Med, Boston, MA USA
[5] Harvard Univ, Sch Med, Boston, MA USA
[6] Boston Childrens Hosp, Dept Med, Div Infect Dis, Boston, MA USA
[7] Boston Childrens Hosp, Dept Lab Med, Boston, MA USA
[8] Ctr Medicare & Medicaid Serv, Boston, MA USA
[9] Inst Healthcare Improvement, Boston, MA USA
关键词
central line-associated bloodstream infections; ventilator-associated pneumonia; catheter-associated urinary tract infections; health care-associated infections; Medicaid; VENTILATOR-ASSOCIATED PNEUMONIA; BLOOD-STREAM INFECTIONS; NEONATAL INTENSIVE-CARE; URINARY-TRACT-INFECTION; LATE-ONSET SEPSIS; UNIT-ACQUIRED INFECTIONS; BIRTH-WEIGHT INFANTS; QUALITY-IMPROVEMENT; RESEARCH NETWORK; SURVEILLANCE;
D O I
10.1542/peds.2014-0613
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
BACKGROUND: Health care-associated infections (HAIs) are harmful and costly and can result in substantial morbidity for hospitalized children; however, little is known about national trends in HAIs in neonatal and pediatric populations. Our objective was to determine the incidence of HAIs among a large sample of hospitals in the United States caring for critically ill children from 2007 to 2012. METHODS: In this cohort study, we included NICUs and PICUs located in hospitals reporting data to the Centers for Disease Control and Prevention's National Healthcare Safety Network for central line-associated bloodstream infections (CLABSIs), ventilator-associated pneumonias, and catheter-associated urinary tract infections. We used a time-series design to evaluate changes in HAI rates. RESULTS: A total of 173 US hospitals provided data from NICUs, and 64 provided data from PICUs. From 2007 to 2012, rates of CLABSIs decreased in NICUs from 4.9 to 1.5 per 1000 central-line days (incidence rate ratio (IRR) per quarter = 0.96, 95% confidence interval 0.94-0.97) and in PICUs from 4.7 to 1.0 per 1000 centralline days (IRR per quarter = 0.96 [0.94-0.98]). Rates of ventilatorassociated pneumonias decreased in NICUs from 1.6 to 0.6 per 1000 ventilator days (IRR per quarter = 0.97 [0.93-0.99]) and PICUs from 1.9 to 0.7 per 1000 ventilator-days (IRR per quarter = 0.95 [0.92-0.98]). Rates of catheter-associated urinary tract infections did not change significantly in PICUs. CONCLUSIONS: Between 2007 and 2012 there were substantial reductions in HAIs among hospitalized neonates and children. Pediatrics 2014; 134: 705-712
引用
收藏
页码:705 / 712
页数:8
相关论文
共 50 条
  • [41] Health care worker perspectives of their motivation to reduce health care-associated infections
    McClung, Laura
    Obasi, Chidi
    Knobloch, Mary Jo
    Safdar, Nasia
    AMERICAN JOURNAL OF INFECTION CONTROL, 2017, 45 (10) : 1064 - 1068
  • [42] Hospital- and System-Wide Interventions for Health Care-Associated Infections: A Systematic Review
    Maurer, Nicholas R.
    Hogan, Tory H.
    Walker, Daniel M.
    MEDICAL CARE RESEARCH AND REVIEW, 2021, 78 (06) : 643 - 659
  • [43] Perceived impact of the Medicare policy to adjust payment for health care-associated infections
    Lee, Grace M.
    Hartmann, Christine W.
    Graham, Denise
    Kassler, William
    Linn, Maya Dutta
    Krein, Sarah
    Saint, Sanjay
    Goldmann, Donald A.
    Fridkin, Scott
    Horan, Teresa
    Jernigan, John
    Jha, Ashish
    AMERICAN JOURNAL OF INFECTION CONTROL, 2012, 40 (04) : 314 - 319
  • [44] Impact of tooth brushing on oral bacteriota and health care-associated infections among ventilated COVID-19 patients: an intervention study
    Iwona, Gregorczyk-Maga
    Anna, Palka
    Mateusz, Fiema
    Michal, Kania
    Anna, Kujawska
    Pawel, Maga
    Estera, Jachowicz-Matczak
    Dorota, Romaniszyn
    Agnieszka, Chmielarczyk
    Barbara, Zoltowska
    Jadwiga, Wojkowska-Mach
    ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL, 2023, 12 (01)
  • [45] Comparison of Health Care-Associated Enterococcus faecium and Enterococcus faecalis Bloodstream Infections
    Alkan-Ceviker, Sevil
    Gunal, Ozgur
    Koksal, Eda
    Aygun, Cemanur
    Kilic, Suleyman Sirri
    KLIMIK JOURNAL, 2020, 33 (01) : 87 - 90
  • [46] Risk Factors for Health Care-Associated Bloodstream Infections in NICUs
    Johnson, Julia
    Malwade, Sudhir
    Agarkhedkar, Sharad
    Randive, Bharat
    Rajput, Uday C.
    Valvi, Chhaya
    Kinikar, Aarti
    Parikh, Tushar B.
    Vaidya, Umesh
    Kadam, Abhay
    Ouddi, Basma
    Smith, Rachel M.
    Westercamp, Matthew
    Mave, Vidya
    Schumacher, Christina
    Coffin, Susan E.
    Robinson, Matthew L.
    Gupta, Amita
    Manabe, Yukari C.
    Milstone, Aaron M.
    JAMA NETWORK OPEN, 2025, 8 (03)
  • [47] Evaluation of health care-associated infections following radical cystectomy
    Garcia-Rojo, E.
    Medina-Polo, J.
    Miranda-Utrera, N.
    Abad-Lopez, P.
    Gonzalez-Padilla, D. A.
    Gonzalez-Diaz, A.
    Arrebola-Pajares, A.
    Guerrero-Ramos, F.
    Tejido-Sanchez, A.
    Rodriguez-Antolin, A.
    ACTAS UROLOGICAS ESPANOLAS, 2021, 45 (02): : 124 - 131
  • [48] Health Care-Associated Infections in Older Adults Epidemiology and Prevention
    Tesini, Brenda L.
    Dumyati, Ghinwa
    INFECTIOUS DISEASE CLINICS OF NORTH AMERICA, 2023, 37 (01) : 65 - 86
  • [49] Health care-associated infections after major cancer surgery
    Sammon, Jesse
    Trinh, Vincent Q.
    Ravi, Praful
    Sukumar, Shyam
    Gervais, Mai-Kim
    Shariat, Shahrokh F.
    Larouche, Alexandre
    Tian, Zhe
    Kim, Simon P.
    Kowalczyk, Keith J.
    Hu, Jim C.
    Menon, Mani
    Karakiewicz, Pierre I.
    Quoc-Dien Trinh
    Sun, Maxine
    CANCER, 2013, 119 (12) : 2317 - 2324
  • [50] Changes in antimicrobial resistance and outcomes of health care-associated infections
    Aydin, Mehtap
    Azak, Emel
    Bilgin, Huseyin
    Menekse, Sirin
    Asan, Ali
    Mert, Habibe Tulin Elmaslar
    Yulugkural, Zerrin
    Altunal, Lutfiye Nilsun
    Hatipoglu, Cigdem Ataman
    Ertem, Gunay Tuncer
    Altunok, Elif Sargin
    Demirkaya, Melike Hamiyet
    Ceviker, Sevil Alkan
    Akgul, Fethiye
    Memis, Zeynep
    Konya, Petek
    Azap, Alpay
    Aydin, Gule
    Korkmaz, Derya
    Karakoc, Zehra Cagla
    Yapar, Derya
    Karakecili, Faruk
    Gunal, Ozgur
    Keske, Siran
    Kapmaz, Mahir
    Kader, Cigdem
    Demirel, Aslihan
    Ergonul, Onder
    EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2021, 40 (08) : 1737 - 1742