Prospective Study Estimating Healthcare Associated Infections in a Paediatric Hemato-oncology Unit of a Tertiary Care Hospital in North India

Overview

Journal Indian J Med Res

Specialty General Medicine

Date 2014 Feb 14

PMID 24521640

Citations 1

Authors

Ayush Gupta

Arti Kapil

S K Kabra

Rakesh Lodha

Seema Sood

Benu Dhawan

Bimal K Das

V Sreenivas

Affiliations

Soon will be listed here.

Abstract

Background & Objectives: Healthcare associated infections (HAIs) are responsible for morbidity and mortality among immunocompromised and critically ill patients. We undertook this study to estimate the burden of HAIs in the paediatric cancer patients in a tertiary care hospital in north India.

Methods: This prospective, observational study, based on active surveillance for a period of 11 months was undertaken in a 4-bedded isolated, cubicle for paediatric cancer patients. Patients who stayed in the cubicle for ≥48 h, were followed prospectively for the development of HAIs.

Results: Of the 138 patients, 13 developed 14 episodes of HAIs during the study period. Patient-days calculated were 1273 days. Crude infection rate (CIR) and incidence density (ID) of all HAIs were 9.4/100 patients and 11/1000 patient-days, respectively. Of the 14 episodes of HAIs, seven (50%) were of blood stream infections (HA-BSI), five (36%) of pneumonia (HAP) and two (14%) urinary tract infections (HA-UTI). The CIRs of HA-BSI, HAP and HA-UTI were 5.1, 3.6 and 1.4/100 patients, respectively. The corresponding IDs were 5.5, 3.9 and 1.6/1000 patient-days, respectively. Mean length of stay was significantly higher in patients who developed an HAI [13.8 (range 7-30), median (Interquartile range) 12 (11-14)] vs 7.5 days [range 2-28, median (interquartile range) 7 (5-9); P<0.0001]. Also mortality was significantly higher in patients who developed an HAI [23% (3/13) vs 3% (4/125), P<0.05].

Interpretation & Conclusions: The incidence of HAIs in the paediatric cancer patients in the study was 11/1000 patient days, of which HA-BSIs were the commonest. HAIs were associated with an increase in morbidity and mortality amongst this high risk patient population.

Citing Articles

Microbiological profile and their antibiogram of bloodstream infections amongst first and second surge of the COVID-19 patients in a tertiary care hospital.

Saini V, Nirmal K, Ahmad N, Das S, Singh N J Family Med Prim Care. 2023; 11(11):7367-7371.

PMID: 36993004 PMC: 10041244. DOI: 10.4103/jfmpc.jfmpc_770_22.

References

Prabhash K, Medhekar A, Ghadyalpatil N, Noronha V, Biswas S, Kurkure P . Blood stream infections in cancer patients: a single center experience of isolates and sensitivity pattern. Indian J Cancer. 2010; 47(2):184-8. DOI: 10.4103/0019-509X.63019. View

Patra P, Jayashree M, Singhi S, Ray P, Saxena A . Nosocomial pneumonia in a pediatric intensive care unit. Indian Pediatr. 2007; 44(7):511-8. View

Castagnola E, Conte M, Parodi S, Papio F, Caviglia I, Haupt R . Incidence of bacteremias and invasive mycoses in children with high risk neuroblastoma. Pediatr Blood Cancer. 2006; 49(5):672-7. DOI: 10.1002/pbc.21070. View

Gupta A, Kapil A, Lodha R, Kabra S, Sood S, Dhawan B . Burden of healthcare-associated infections in a paediatric intensive care unit of a developing country: a single centre experience using active surveillance. J Hosp Infect. 2011; 78(4):323-6. DOI: 10.1016/j.jhin.2011.04.015. View

Lakshmi K, Jayashree M, Singhi S, Ray P . Study of nosocomial primary bloodstream infections in a pediatric intensive care unit. J Trop Pediatr. 2006; 53(2):87-92. DOI: 10.1093/tropej/fml073. View

Urrea M, Rives S, Cruz O, Navarro A, Garcia J, Estella J . Nosocomial infections among pediatric hematology/oncology patients: results of a prospective incidence study. Am J Infect Control. 2004; 32(4):205-8. DOI: 10.1016/j.ajic.2003.10.013. View

Simon A, Ammann R, Bode U, Fleischhack G, Wenchel H, Schwamborn D . Healthcare-associated infections in pediatric cancer patients: results of a prospective surveillance study from university hospitals in Germany and Switzerland. BMC Infect Dis. 2008; 8:70. PMC: 2408583. DOI: 10.1186/1471-2334-8-70. View

Castagnola E, Molinari A, Giacchino M, Chiapello N, Moroni C, Caviglia I . Incidence of catheter-related infections within 30 days from insertion of Hickman-Broviac catheters. Pediatr Blood Cancer. 2005; 48(1):35-8. DOI: 10.1002/pbc.20724. View

Castagnola E, Cesaro S, Giacchino M, Livadiotti S, Tucci F, Zanazzo G . Fungal infections in children with cancer: a prospective, multicenter surveillance study. Pediatr Infect Dis J. 2006; 25(7):634-9. DOI: 10.1097/01.inf.0000220256.69385.2e. View

10.

Singhi S, Ray P, Mathew J, Jayashree M . Nosocomial bloodstream infection in a pediatric intensive care unit. Indian J Pediatr. 2008; 75(1):25-30. DOI: 10.1007/s12098-008-0002-0. View

11.

Laws H, Kobbe G, Dilloo D, Dettenkofer M, Meisel R, Geisel R . Surveillance of nosocomial infections in paediatric recipients of bone marrow or peripheral blood stem cell transplantation during neutropenia, compared with adult recipients. J Hosp Infect. 2005; 62(1):80-8. DOI: 10.1016/j.jhin.2005.05.010. View

12.

Haupt R, Romanengo M, Fears T, Viscoli C, Castagnola E . Incidence of septicaemias and invasive mycoses in children undergoing treatment for solid tumours: a 12-year experience at a single Italian institution. Eur J Cancer. 2001; 37(18):2413-9. DOI: 10.1016/s0959-8049(01)00274-x. View

13.

Mathur P, Kapil A, Das B . Nosocomial bacteraemia in intensive care unit patients of a tertiary care centre. Indian J Med Res. 2006; 122(4):305-8. View

14.

Horan T, Andrus M, Dudeck M . CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008; 36(5):309-32. DOI: 10.1016/j.ajic.2008.03.002. View

15.

Simon A, Fleischhack G, Hasan C, Bode U, Engelhart S, Kramer M . Surveillance for nosocomial and central line-related infections among pediatric hematology-oncology patients. Infect Control Hosp Epidemiol. 2000; 21(9):592-6. DOI: 10.1086/501809. View

16.

Paulus S, van Saene H, Hemsworth S, Hughes J, Ng A, Pizer B . A prospective study of septicaemia on a paediatric oncology unit: a three-year experience at The Royal Liverpool Children's Hospital, Alder Hey, UK. Eur J Cancer. 2005; 41(14):2132-40. DOI: 10.1016/j.ejca.2005.04.037. View