Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Trop Pediatr. 2011 Oct;57(5):357-62. doi: 10.1093/tropej/fmq104. Epub 2010 Nov 18.
Nosocomial urinary tract infections (NUTI) are one of the commonest infections in a Pediatric Intensive Care Unit (PICU). This prospective study was conducted in PICU between January and December 2008 to study the incidence, organisms and risk factors for NUTI. A total of 287 consecutive patients with >48 h PICU stay and sterile admission urine culture, were enrolled and monitored for NUTI (defined as per CDC criteria 1988) till discharge or death. Patients with and without NUTI were compared with respect to demographics, PRISM scores, primary diagnosis, nutritional status and device utilization to identify risk factors. Outcome was defined as length of PICU stay and survival or death. There were 69 episodes of UTI in 60 (20.9%) patients; incidence being 18 episodes/1000 patient days. Candida (52.1%) and Enterococcus (13%) were commonest followed by Escherichia coli (11.6%) and Klebsiella pneumoniae (10.1%). Catheterization and duration of catheterization were the risk factors for NUTI (p < 0.001). The median length of PICU stay was significantly longer in NUTI group compared to non-NUTI group (19 vs. 8 days, p = 0.001). Mortality rates in both the groups were similar.
医院获得性尿路感染（NUTI）是儿科重症监护病房（PICU）中最常见的感染之一。本前瞻性研究于 2008 年 1 月至 12 月在 PICU 进行，旨在研究 NUTI 的发病率、病原体和危险因素。共有 287 例入住 PICU 超过 48 小时且无菌入院尿培养的连续患者入组并监测 NUTI（根据 CDC 1988 标准定义）直至出院或死亡。比较了有和无 NUTI 的患者的人口统计学、PRISM 评分、主要诊断、营养状况和器械使用情况，以确定危险因素。结果定义为 PICU 住院时间和生存或死亡。60 例（20.9%）患者发生 69 次 UTI，发病率为 18 次/1000 患者日。最常见的病原体是念珠菌（52.1%）和肠球菌（13%），其次是大肠杆菌（11.6%）和肺炎克雷伯菌（10.1%）。置管和置管时间是 NUTI 的危险因素（p < 0.001）。与非 NUTI 组相比，NUTI 组的 PICU 住院时间中位数明显更长（19 天 vs. 8 天，p = 0.001）。两组的死亡率相似。
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