Prevalence and risk factors of infection in Pediatric Intensive Care Unit at Thammasat University Hospital.

BACKGROUND

infection (ABI) is a concerning worldwide public health matter with high levels of morbidity and mortality, particularly in critically ill patients. This study aims to assess the prevalence, risk factors, and clinical outcomes of ABI in the pediatric intensive care unit (PICU) setting.

METHODS

A retrospective review was performed on pediatric patients admitted to the PICU over an 8-year period. Demographic characteristics, infection risk factors, and clinical outcomes were compared and analyzed between patients with ABI, determined to be the case group, and patients without ABI, determined to be the control group. The study also assessed the prevalence of ABI and its antimicrobial resistance profile.

RESULTS

Between June 2014 and May 2022, a total of 82 cases of ABI were identified, resulting in an overall prevalence of 5.02%. After applying the exclusion criteria, 12 cases were excluded. Consequently, 70 ABI cases in total and 140 cases in a control group were included in the study. Multivariable conditional logistic regression analysis identified chronic respiratory disease, mechanical ventilation lasting 5 days or more, and the use of piperacillin/tazobactam within the last 2 weeks as independent risk factors associated with ABI. The rate of carbapenem-resistant (CRAB) was notably high at 94.26%. Cases of ABI were associated with higher mortality rates and prolonged hospitalization compared to non-ABI cases.

CONCLUSION

ABI remains a critical pathogen in the PICU. The presence of chronic respiratory disease, use of mechanical ventilation for at least five days, and a history of receiving piperacillin/tazobactam within the last 2 weeks are significant risk factors for ABI. The high level of antibiotic resistance, especially to carbapenems, highlights the emphasis for more stringent infection control practices and the creation of novel antimicrobial therapies.