Epidemiology of nosocomial infections in a pediatric intensive care unit (PICU)

Background: Nosocomial infections (NI) are major concerns in the management of patients in hospitals and are growing problem in developing and developed countries because of increased mortality and morbidity rates and corresponding costs. Patients and methods: This cross sectional study was carried out on all patients hospitalized for more than 48 hours in pediatric intensive care unit (PICU) of Rasul Akram hospital in Tehran. Nosocomial infection was defined according to the criteria of National Nosocomial Infections Surveillance (NNIS) system. Results: During the study period, 102 patients were hospitalized of whom 15 (14.7%) proved to have NI. The mean duration of PICU stay was 16.1 days for NI group and 8.9 days for non-NI group (p < 0.05). Mortality rate was significantly higher among NI group (40%) when compared with non-NI group (11.5%) (OR=5.13, 95%CI:1.29-20.60, p < 0.05). Age under 2 years was a risk factor for NI (OR=4.44, 95%CI:1.23-16.67). The most common causative organisms for nosocomial infections in PICU were coagulase-negative staphylococci (CONS), followed by Klebsiella and Pseudomonas aeruginosa. Pneumonia was the most common nosocomial infection, followed by urinary tract infection and sepsis. Conclusion: The calculated NI rate in our study (14.7%) is higher than usual rates reported from PICU in other societies. Meanwhile, long stay in PICU and age less than 2 years are the main risk factor for NI and subjects with NI are 5.13 times more likely to die.