Department of Child Health, Dr. Sardjito Hospital, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jalan Kesehatan No 1, Sekip, Yogyakarta, 55281, Indonesia.
Centre for Child Health-Pediatric Research Office (CCH-PRO), Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
BMC Infect Dis. 2022 Apr 26;22(1):406. doi: 10.1186/s12879-022-07387-2.
Healthcare-associated infections (HAI) are one of significant causes of morbidity and mortality. Evaluating risk factors associated with HAI are important to improve clinical outcomes. We aimed to evaluate the risk factors of HAI in children in a low-to middle-income country.
A prospective cohort study was conducted during 43 months at a teaching hospital in Yogyakarta, Indonesia. All consecutive patients admitted to pediatric ICU and pediatric wards > 48 h were eligible. Those eligible patients were observed daily to identify the presence of HAI based on CDC criteria. The risk factors of HAI were identified. Multivariable logistic regression was used to identify independent risk factors.
Total of 2612 patients were recruited. Of 467 were diagnosed as HAI. The cumulative incidence of HAI was 17.9%. In the multivariable analysis; length of stay > 7 days, severe sepsis, use of urine catheter, central venous catheter (CVC), non-standardized antibiotics, and aged < 1 year were independently associated with increased risk of HAI with adjusted OR (95%CI): 5.6 (4.3-7.3), 1.9 (1.3-2.9), 1.9 (1.3-2.6), 1.8 (1.1-2.9), 1.6 (1.2-2.0), and 1.4 (1.1-1.8), respectively.
This study found that length of stay > 7 days, use of urine catheter and CVC, non-standardized antibiotic use, aged < 1 year, and had a diagnosis of severe sepsis increased risk of HAI.
医疗保健相关感染（HAI）是发病率和死亡率的重要原因之一。评估与 HAI 相关的危险因素对于改善临床结局至关重要。我们旨在评估中低收入国家儿童 HAI 的危险因素。
在印度尼西亚日惹的一家教学医院进行了一项前瞻性队列研究，历时 43 个月。所有连续入住儿科 ICU 和儿科病房超过 48 小时的患者均符合条件。对符合条件的患者进行每日观察，根据 CDC 标准确定 HAI 的存在。确定 HAI 的危险因素。使用多变量逻辑回归来确定独立的危险因素。
共招募了 2612 名患者。其中 467 例被诊断为 HAI。HAI 的累积发病率为 17.9%。在多变量分析中；住院时间超过 7 天、严重败血症、使用导尿管、中心静脉导管（CVC）、非标准化抗生素和年龄<1 岁与 HAI 的风险增加独立相关，调整后的 OR（95%CI）为：5.6（4.3-7.3）、1.9（1.3-2.9）、1.9（1.3-2.6）、1.8（1.1-2.9）、1.6（1.2-2.0）和 1.4（1.1-1.8）。
本研究发现，住院时间超过 7 天、使用导尿管和 CVC、使用非标准化抗生素、年龄<1 岁以及患有严重败血症会增加 HAI 的风险。
