Trends in Nosocomial Blood Stream Infection in PICU of a Tertiary Care Hospital

Authors

  • Umer Waqar Azeem Department of Pediatric Medicine, Children Hospital, Lahore, University of Child Health Sciences, Lahore Pakistan
  • Nighat Sultana Department of Pediatric Medicine, Children Hospital, Lahore, University of Child Health Sciences, Lahore Pakistan
  • Muhammad Sarwar Department of Pediatric Medicine, Children Hospital, Lahore, University of Child Health Sciences, Lahore Pakistan
  • Ghazala Shaffqat Department of Pediatric Medicine, Children Hospital and Institute of Child Health, Faisalabad Pakistan
  • Anila Jamil Department of Pediatric Medicine, Children Hospital, Lahore, University of Child Health Sciences, Lahore Pakistan
  • Sana Jamil Department of Pediatric Medicine, Children Hospital, Lahore, University of Child Health Sciences, Lahore Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i6.9031

Keywords:

Bloodstream infections, Community-acquired infections, Gram positive, Nosocomial.

Abstract

Objective: To determine the local pathogens and antimicrobial sensitivity pattern in the Pediatric intensive care unit of Children Hospital Lahore and its impact on patients’ outcomes.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Pediatric intensive care unit of Children Hospital, Lahore Pakistan from Feb 2021 to Feb 2022.

Methodology: All the children who were admitted to Pediatric intensive care unit during the study period were included; those having positive blood culture at admission, discharged, or who died within the 48 hours of admission were excluded. Blood cultures were sent after 48 hours of admission in patients having features suggestive of nosocomial BSI; those having positive blood cultures were considered to have nosocomial bloodstream infection(BSI) as per the definition of CDC. Demographic, microbiological, and other variables were documented.

Results: The mean age of patients was 3.0± 4.7 with age ranges from 1 month to 14 years 734(63.9%) were males and 423 (36.1%) were females. The bloodstream infection was confirmed by a positive blood culture report in 169(14.7%) patients. The normage of patients with BSI (n=169) was 1.6 ±6.04 and the average duration of stay of children with nosocomial BSI was 15.0± 39.97 (p-value < 0.001). The average days of mechanical ventilation in children with nosocomial BSI were 9.0±37.04 (p-value = 0.003).  Among the 

Conclusion: The frequency of nosocomial BSI in PICU is quite high, which in turn is associated with a longer duration of stay and poor outcomes. The emergence of highly resistant organisms,

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Author Biographies

  • Nighat Sultana, Department of Pediatric Medicine, Children Hospital, Lahore, University of Child Health Sciences, Lahore Pakistan
     
  • Muhammad Sarwar, Department of Pediatric Medicine, Children Hospital, Lahore, University of Child Health Sciences, Lahore Pakistan

    Associate Professor, PICU.

    Children Hospital, Lahore – University of Child Health Sciences

  • Sana Jamil, Department of Pediatric Medicine, Children Hospital, Lahore, University of Child Health Sciences, Lahore Pakistan

    Senior Registrar.

    Children Hospital, Lahore – University of Child Health Sciences

References

Tauhid SA, Chowdhury M, Hoque MM, Haque E. Nosocomial bloodstream infections in children in intensive care unit: organisms, sources, their sensitivity pattern, and outcome of treatment. J Bangladesh Coll Physicians Surg 2017; 35(3): 115-122. https://doi.org/10.3329/jbcps.v35i3.34341

Porto JP, Mantese OC, Arantase A, Freitas C, Filho PPG, Ribas RM. Nosocomial infections in a pediatric intensive care unit of a developing country: NHSN surveillance. Rev Soc Bras Med Trop 2012; 45(4): 475-479. https://doi.org/10.1590/S0037-86822012005000003

Hamid MH, Zafar A, Maqbool S. Nosocomial bloodstream infection in a tertiary care pediatric intensive care unit. J Coll Physicians Surg Pak 2007; 17(7): 416-419.

Pourakbari B, Rezaizadeh G, Mahmoudi S, Mamishi S. Epidemiology of nosocomial infections in pediatric patients in an Iranian referral hospital. J Prev Med Hyg 2012; 53: 204-206.

Prowle JR, Echeverri JE, Ligabo EV, Sherry N, Taori GC, Crozier TM, et al. Acquired bloodstream infection in the intensive care unit: incidence and attributable mortality. Crit Care 2011; 15(2): 100.

https://doi.org/10.1186/cc10114

Ferrer R, Loeches MI, Phillips G, Osborn TM, Townsend S, Dellinger RP, et al. Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: results from a guideline-based performance improvement program. Crit Care Med 2014; 42(8): 1749-1755. https://doi.org/10.1097/CCM.0000000000000330

Richards MJ, Edwards JR, Culver DH, Gaynes RP. Nosocomial infections in pediatric intensive care units in the United States. Natl Nosocomial Infections Surveillance System. Crit Care Med 1999; 27(5): 887-892.

https://doi.org/10.1542/peds.103.4.e39

Ahmed SH, Daef EA, Badary MS, Mahmoud MA, AbdElsayed AA. Nosocomial bloodstream infection in intensive care units at Assiut University Hospitals with special reference to extended spectrum beta-lactamase producing organisms. BMC Res Notes 2009; 2: 76. https://doi.org/10.1186/1756-0500-2-76

Lakshmi KS, Jayashree M, Singhi S, Ray P. Study of nosocomial primary bloodstream infections in a pediatric intensive care unit. J Trop Pediatr 2007; 53(2): 87-92.

https://doi.org/10.1093/tropej/fml073

Parajuli NP, Parajuli H, Pandit R. Evaluating the trends of bloodstream infections among pediatric and adult patients at a teaching hospital of Kathmandu, Nepal: role of drug-resistant pathogens. Can J Infect Dis Med Microbiol 2017; 2017: 8763135.

https://doi.org/10.1155/2017/8763135

Cui J, Li M, Wang J. The incidence rate, species distribution and dynamic trends of bloodstream infection in China. Res Sq 2020. https://doi.org/10.21203/rs.3.rs-27335/v1

Rezk AR, Bawady SA, Omar NN. Incidence of emerging multidrug-resistant organisms and its impact on the outcome in the pediatric intensive care. Egypt Pediatr Assoc Gaz 2021; 69: 25. https://doi.org/10.1186/s43054-021-00071-1

Asanathong NW, Rongrungreung Y, Assanasen S. Epidemiology and trends of important pediatric healthcare-associated infections at Siriraj Hospital, Thailand. Southeast Asian J Trop Med Public Health 2017; 48(3): 641-654.

Ulus A, Kara SS, Çelik E. An evaluation of pediatric intensive care unit infection rates and various risk factors. Trends Pediatr 2020; 1(2): 75-80.

https://doi.org/10.5222/TP.2020.66376

Ayaz I, Hameed H, Amber W, Zafar T. Nosocomial bloodstream infections in pediatric intensive care unit of Fauji Foundation Hospital, Rawalpindi Pakistan. J Islamabad Med Dent Coll 2020; 9(4): 269-274.

https://doi.org/10.35787/jimdc.v9i4.533

Duan N, Sun L, Huang C. Microbial distribution and antibiotic susceptibility of bloodstream infections in different intensive care units. Front Microbiol 2021; 12: 792282.

https://doi.org/10.3389/fmicb.2021.792282

Canadian Nosocomial Infection Surveillance Program. Device-associated infections in Canadian acute-care hospitals from 2009 to 2018. Can Commun Dis Rep 2020; 46(11/12): 387-397.

https://doi.org/10.14745/ccdr.v46i1112a05

World Health Organization. WHO strategic priorities on antimicrobial resistance: preserving antimicrobials for today and tomorrow. Geneva: World Health Organization; 2022 (Internet). ISBN 978-92-4-004139-4. Available at:

https://www.who.int/publications/i/item/9789240041387 [Accessed on March 27, 2022].

Havan M, Kendirli T, Perk O. A major clinical challenge in pediatric intensive care unit with pandrug-resistant OXA-48 Klebsiella pneumoniae outbreak. Pediatr Crit Care Med 2018; 19(6S): 106.

https://doi.org/10.1097/01.pcc.0000537648.97463.28

Saeed N, Usman M, Khan EA. An overview of extensively drug-resistant Salmonella Typhi from a tertiary care hospital in Pakistan. Cureus 2019; 11(9): e5663.

https://doi.org/10.7759/cureus.5663

Hughes MJ, Birhane MG, Dorough L. Extensively drug-resistant typhoid fever in the United States. Open Forum Infect Dis 2021; 8(12): ofab572.

https://doi.org/10.1093/ofid/ofab572

Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet 2022; 399: 629-655.

https://doi.org/10.1016/S0140-6736(21)02724-0

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Published

31-12-2024

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Original Articles

How to Cite

1.
Azeem UW, Sultana N, Sarwar M, Shaffqat G, Jamil A, Jamil S. Trends in Nosocomial Blood Stream Infection in PICU of a Tertiary Care Hospital. Pak Armed Forces Med J [Internet]. 2024 Dec. 31 [cited 2025 Feb. 22];74(6):1536-9. Available from: https://pafmj.org/PAFMJ/article/view/9031