Multidrug-resistant hospital-associated infections in a pediatric intensive care unit: a cross-sectional survey in a Thai university hospital

• DOI: 10.1016/j.ijid.2008.08.022
• Publication Date: 2008-12-10T16:11:32Z
• Authors: Suchada Sritippay...; Klaita Sri-Singh; Nuanchan Prapphal; Rujipat Samransam...; Jitladda Deerojan...
• Keywords: Microbiology (medical); Male; Hospital-associated infection; Cross Infection; Adolescent; Intensive Care Units, Pediatric; Thailand; Health Surveys; Anti-Bacterial Agents; 3. Good health; 03 medical and health sciences; Infectious Diseases; Cross-Sectional Studies; 0302 clinical medicine; Risk Factors; Child, Preschool; Humans; Multidrug-resistant; Pediatric intensive care unit; Female; Prospective Studies; Child

To determine the incidence and associated factors of multidrug-resistant hospital-associated infections (MDR-HAI) in a pediatric intensive care unit (PICU) of a university hospital in Thailand.A prospective study was performed in the PICU of King Chulalongkorn Memorial Hospital during the period May-December 2005. Children aged < or = 15 years who developed a PICU-related HAI were studied.Forty-four patients (median age 6 months; male:female = 1.4:1) developed 58 episodes of PICU-related HAI. The HAI rate was 28.3 per 1000 patient-days. Thirty episodes (52%) were MDR-HAI. The following were found more frequently in MDR-HAI when compared to non-MDR-HAI: Acinetobacter baumannii (50% vs. 23%, p = 0.04), female sex (60% vs. 29%, p = 0.02), admission to the PICU with a medical condition (90% vs. 64%, p = 0.03), PICU stay longer than 7 days prior to the development of HAI (67% vs. 36%, p = 0.03), and previous use of broad-spectrum antibiotics (83% vs. 43%, p = 0.002). Independent risk factors for MDR-HAI included female sex (OR = 5.5, p = 0.03) and previous use of a broad-spectrum antibiotic (OR = 9.7, p = 0.01).The incidence of MDR-HAI was high in the PICU. Female sex and previous use of a broad-spectrum antibiotic were independent risk factors for MDR-HAI.