Moolasart Visal, Srijareonvijit Chaisiri, Charoenpong Lantharita, Kongdejsakda Winnada, Anugulruengkitt Suvaporn, Kulthanmanusorn Anond, Thienthong Varaporn, Usayaporn Sang, Kaewkhankhaeng Wanwisa, Rueangna Oranat, Sophonphan Jiratchaya, Manosuthi Weerawat, Tangcharoensathien Viroj
Bamrasnaradura Infectious Diseases Institute, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand.
Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
Children (Basel). 2024 Jun 17;11(6):738. doi: 10.3390/children11060738.
Healthcare-associated infections (HAIs) pose a grave threat to patient safety, morbidity, and mortality, contributing to antimicrobial resistance. Thus, we estimated the point prevalence, risk factors, types, and pathogens of HAIs in hospitalized pediatric patients.
A point prevalence survey (PPS) of HAIs in hospitalized pediatric patients < 18 years old was conducted from March to May 2021. Outcomes, risk factors, and types of HAIs associated with HAIs in 41 hospitals across Thailand were collected.
The prevalence of HAIs was 3.9% (95% CI 2.9-5.0%) (56/1443). By ages < 1 month, 1 month-2 years, 2-12 years, and 12-18 years, the prevalence of HAIs was 4.2%, 3.3%, 4.1%, and 3.0%, respectively ( = 0.80). Significant independent risk factors were extended hospital length of stay (LOS) and central venous catheter (CVC) use. Compared to an LOS of <4 days, LOSs of 4-7 days, 8-14 days, and >14 days had adjusted odds ratios (aORs) of 2.65 (95% CI 1.05, 6.68), 5.19 (95% CI 2.00, 13.4), and 9.03 (95% CI 3.97, 20.5), respectively. The use of a CVC had an aOR of 2.45 (95% CI 1.06-5.66). Lower respiratory tract infection (LRTI) was the most common HAI type (46.4%: 26/56). The highest prevalence of HAIs was predominantly observed in LRTI diagnoses, with the highest among these in the <1 month age category at 2.3% (17/738).
The prevalence of HAIs in hospitalized pediatric patients was 3.9%. Extended LOS and use of CVC were HAI risk factors. A strategy for reducing LOS and reviewing insertion indications or the early planned removal of a CVC was implemented. The surveillance of HAIs stands as a cornerstone and fundamental component of IPC, offering invaluable insights that enhance hospital IPC interventions aimed at preventing HAIs.
医疗保健相关感染（HAIs）对患者安全、发病率和死亡率构成严重威胁，助长了抗菌药物耐药性。因此，我们估计了住院儿科患者中HAIs的现患率、危险因素、类型和病原体。
于2021年3月至5月对18岁以下住院儿科患者进行HAIs现患率调查（PPS）。收集了泰国41家医院与HAIs相关的结局、危险因素和HAIs类型。
HAIs的现患率为3.9%（95%可信区间2.9 - 5.0%）（56/1443）。按年龄＜1个月、1个月至2岁、2至12岁和12至18岁划分，HAIs的现患率分别为4.2%、3.3%、4.1%和3.0%（P = 0.80）。显著的独立危险因素为住院时间延长和中心静脉导管（CVC）的使用。与住院时间＜4天相比，住院时间为4至7天、8至14天和＞14天的调整优势比（aORs）分别为2.65（95%可信区间1.05，6.68）、5.19（95%可信区间2.00，13.4）和9.03（95%可信区间3.97，20.5）。使用CVC的aOR为2.45（95%可信区间1.06 - 5.66）。下呼吸道感染（LRTI）是最常见的HAIs类型（46.4%：26/56）。HAIs的最高现患率主要见于LRTI诊断中，其中＜1个月年龄组最高，为2.3%（17/738）。
住院儿科患者中HAIs的现患率为3.9%。住院时间延长和CVC的使用是HAIs的危险因素。实施了一项缩短住院时间并审查置入指征或尽早计划拔除CVC的策略。HAIs监测是感染预防与控制（IPC）的基石和基本组成部分，提供了宝贵的见解，可加强旨在预防HAIs的医院IPC干预措施。
