AETIOLOGY AND RISK FACTORS FOR HOSPITAL-ACQUIRED BACTERAEMIA IN CHILDREN ADMITTED TO A LONDON TERTIARY REFERRAL HOSPITAL
Dr. A Perez-Lopez
11 slide(s) – English – 2011-06-07
Hospital-acquired infections are associated with significant morbidity and mortality because they are often caused by multi-resistant pathogens and usually affect children with serious underlying medical conditions
To describe the aetiology and risk factors for hospital-acquired bacteraemia among children aged <16 years admitted to a London tertiary referral hospital between 2001 and 2009
A standard pro-forma is used by clinical microbiologists at St. George’s Hospital, London, to document the management of all clinically significant bacteraemia. Bacteraemia was considered to be hospital-acquired if the blood culture was taken at least 72 hours after hospital admission in a child with clinical symptoms, signs and/or laboratory markers consistent with infection.
There were 478 episodes of hospital-acquired bacteraemia over the 9-year period, including 254 episodes (53.1%) in the Neonatal Intensive Care Unit (NICU). Central venous catheters were the main foci in both NICU (45%) and the paediatric wards (73%). Gram-positive pathogens were responsible for 185 (83%) cases in the Paediatric wards and 200 (79%) cases in NICU and were caused mainly by coagulase-negative staphylococci (61% and 65%, respectively). Enteric Gram-negative rods were responsible for 36 (16%) cases in the Paediatric wards and 46 (18%) cases in NICU
14% and 17% of cases in NICU and the paediatric wards. Overall, 45% of S. aureus isolates were methicillin-resistant, but none exhibited reduced susceptibility to vancomycin.
Hospital-acquired bacteraemia in children at St. George\'s Hospital were mainly due to central venous catheter infections and caused by Gram-positive organisms. Antimicrobial resistance rates remain low compared to other countries and multi-resistant organisms were rare.