Al Saeghi Nadiya, Al Thuhli Marwah, Al Hamrashi Hajer, Al Shibli Naema, Al Wahaibi Adil, Al Adawi Badriya, Al Yazidi Laila
Department of Child Health, Al Nahda Hospital, Muscat, Oman.
Oman Medical Specialty Board, Muscat, Oman.
Sultan Qaboos Univ Med J. 2024 Nov;24(4):501-506. doi: 10.18295/squmj.7.2024.044. Epub 2024 Nov 27.
This study aimed to assess the local epidemiology and outcome of bloodstream infection (BSI) among Omani children.
This retrospective study was conducted at Sultan Qaboos University Hospital, Muscat, Oman, over 5 years (2014-2018) and included laboratory-confirmed BSI among children aged 0-12 years old. Patients' demographic, clinical and laboratory data were extracted from the hospital's electronic records and used to assess BSI rates and outcomes.
A total of 1,253 positive blood cultures were identified, of which 592 (47.2%) were regarded as contaminants. Overall, 404 (32.2%) significant episodes of BSI were identified in 272 patients; 346 (85.6%) significant episodes were in children aged ≤5 years and 366 (90.6%) had comorbidities. The 5-year incidence of BSI was 13 per 1,000 admissions. Furthermore, 333 (82.4%) episodes were healthcare-related infections. Enterobacterales (n = 152; 37.6%) were the most common organisms identified followed by coagulase-negative staphylococci (n = 63; 15.6%). Approximately 40% of Gram-negative organisms were resistant to third-generation cephalosporins. The crude mortality rate at 30 days was 9.2%. Paediatric intensive care unit admission (crude odds ratio [COR] = 2.24, 95% confidence interval [CI]: 0.98-4.78) and the presence of graft-versus-host disease (COR = 7.99, 95% CI: 1.52-37.76) were associated with increased death within 30 days. The multivariate logistic regression analysis showed that (adjusted odds ratio = 18.46, 95% CI: 3.96-97.84) was the only independent predictor of increasing 30-day mortality in this cohort.
A high rate of hospital-related BSI was found in children in Oman, highlighting the need to optimise infection control strategies and the care of central vein access devices.
本研究旨在评估阿曼儿童血流感染（BSI）的当地流行病学情况及转归。
这项回顾性研究在阿曼马斯喀特的苏丹卡布斯大学医院开展，为期5年（2014 - 2018年），纳入0至12岁儿童中实验室确诊的BSI病例。从医院电子记录中提取患者的人口统计学、临床和实验室数据，用于评估BSI发生率及转归。
共鉴定出1253份阳性血培养物，其中592份（47.2%）被视为污染物。总体而言，在272例患者中识别出404例（32.2%）有意义的BSI发作；346例（85.6%）有意义的发作发生在≤5岁儿童中，366例（90.6%）有合并症。BSI的5年发病率为每1000次入院13例。此外，333例（82.4%）发作是与医疗保健相关的感染。肠杆菌科细菌（n = 152；37.6%）是最常见的鉴定出的微生物，其次是凝固酶阴性葡萄球菌（n = 63；15.6%）。约40%的革兰氏阴性菌对第三代头孢菌素耐药。30天的粗死亡率为9.2%。入住儿科重症监护病房（粗比值比[COR] = 2.24，95%置信区间[CI]：0.98 - 4.78）和移植物抗宿主病的存在（COR = 7.99，95% CI：1.52 - 37.76）与30天内死亡增加相关。多因素逻辑回归分析显示，（调整后的比值比 = 18.46，95% CI：3.96 - 97.84）是该队列中30天死亡率增加的唯一独立预测因素。
在阿曼儿童中发现医院相关BSI的发生率较高，并强调了优化感染控制策略及中心静脉通路装置护理的必要性。
