Evaluation of a New Method of Detection of Nosocomial Infection in the Pediatric Intensive Care Unit: The Infection Control Sentinel Sheet System

1989 ◽  
Vol 10 (11) ◽  
pp. 515-520 ◽  
Author(s):  
E. L. Ford-Jones ◽  
C. M. Mindorff ◽  
E. Pollock ◽  
R. Milner ◽  
D. Bohn ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
New Method

Evaluation of a New Method of Detection of Nosocomial Infection in the Pediatric Intensive Care Unit: The Infection Control Sentinel Sheet System

1989 ◽  
Vol 10 (11) ◽  
pp. 515-520 ◽  
Author(s):  
E.L. Ford-Jones ◽  
C.M. Mindorff ◽  
E. Pollock ◽  
R. Milner ◽  
D. Bohn ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Pediatric Intensive Care Unit ◽  
Nosocomial Infections ◽  
Chart Review ◽  
Pediatric Intensive Care ◽  
Full Time

AbstractTo improve the efficiency of nosocomial infection detection, a highly structured system combining initial reporting by the bedside night nurse of symptoms possibly related to infection with follow-up by the infection control nurse (ICN) was developed: The Infection Control Sentinel Sheet System (ICSSS).Between July 1, 1987 and February 28, 1988, a prospective comparison of results obtained through ICSSS and daily bedside observation/chart review by a full-time trained intensivist was undertaken in the pediatric intensive care unit (PICU). Ratios of nosocomial infections and nosocomially-infected patients were 15.8 and 7.0 respectively among 685 admissions; included are seven infections identified only through the ICSSS so that the “gold standard” became an amalgamation of the two systems. The sensitivity for detection of nosocomially-infected patients by bedside observation/chart review and ICSSS was 100% and 87% respectively. The sensitivity for detection of standard infections (blood, wound and urine) was 88% and 85% respectively. The sensitivity for detection of nosocomial infections at all sites was 94% and 72% respectively. Missed infections were minor (e.g., drain, skin, eye), required physician diagnosis (e.g., pneumonia), were not requested on the sentinel sheet (SS) (e.g., otitis media), related to follow-up of deceased patients or were minor misclassifications or failures to associate with device (e.g., central-line related). Daily PICU surveillance by the ICN required only 20 minutes a day. The ICSSS appears highly promising and has many unmeasured benefits.

Use of the Pediatric Risk of Mortality score to predict nosocomial infection in a pediatric intensive care unit

1991 ◽  
Vol 19 (2) ◽  
pp. 160-165 ◽  
Author(s):  
EVELYN POLLOCK ◽  
E. LEE FORD-JONES ◽  
MARY COREY ◽  
GEOFFREY BARKER ◽  
CATHY M. MINDORFF ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Risk Of Mortality

scholarly journals Nosocomial infection in a pediatric intensive care unit in a developing country

2003 ◽  
Vol 7 (6) ◽  
Author(s):  
Marcelo L. Abramczyk ◽  
Werther B. Carvalho ◽  
Eduardo S. Carvalho ◽  
Eduardo A. S. Medeiros
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Developing Country ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care

scholarly journals 581. The Epidemiology of Imipenem-Resistant Acinetobacter baumannii Bacteremia in a Pediatric Intensive Care Unit and Carbapenem Use

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S274-S275
Author(s):  
Dongsub Kim ◽  
Haejeong Lee ◽  
Christina M Croney ◽  
Ki Sup Park ◽  
Hyo Jung Park ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Acinetobacter Baumannii ◽  
Pediatric Intensive Care Unit ◽  
Antimicrobial Stewardship ◽  
Pediatric Intensive Care ◽  
Tertiary Teaching ◽  
Antimicrobial Resistance Genes ◽  
Days Of Therapy

Abstract Background Acinetobacter baumannii (AB) infections cause high mortality and morbidity in intensive care unit patients. There are limited data on the epidemiology of imipenem-resistant A. baumannii (IRAB) amongst pediatric ICU patients. Methods A retrospective chart review was performed in patients with AB bacteremia in a pediatric intensive care unit at a tertiary teaching hospital from January 2000 to December 2016. Antimicrobial susceptibility tests, multilocus sequence typing (MLST) and PCR for antimicrobial resistance genes were performed for stored isolates. In addition, antibiotic prescription days of therapy (DOT per 1,000 patient-days) of the pediatric department from January 2001 to December 2016 was analyzed. Results Bacteremia episodes occurred in 27 patients. Male patients were 11 (41%) and the median age at the onset of bacteremia was 5.2 years (range, 0–18.6 years). There was a clear shift in antibiogram of AB during the study period. From 2000 to 2003, all isolates were imipenem-sensitive (ISAB, N = 6). From 2005 to 2008, both IRAB (N = 5) and ISAB (N = 4) were isolated. However, since 2009, all the AB isolates were IRAB (N = 12). In 33% (9/27) of patients, first AB was isolated from tracheal aspirate and patients developed bacteremia later (median duration from AB positive tracheal culture to AB positive blood culture, 8 days [range 5–124]). The overall mortality of patients with AB bacteremia was 59.3% (16/27) within 28 days. There was no statistical difference in mortality between ISAB and IRAB groups (50% vs. 71%; P = 0.42). From MLST analysis of 10 available isolates, sequence type 138 was predominant (N = 7). All 10 isolates were positive for OXA-23-like and OXA-51-like carbapenemase. In 2001, carbapenem DOT per 1,000 patient-days was 15.3 and later strikingly raised to 82.5 in 2009 when all the isolates were imipenem resistant. After this IRAB outbreak in PICU, proactive infection control and antimicrobial stewardship were reinforced among multidisciplinary teams in PICU. IRAB outbreak was terminated and carbapenem DOT per 1,000 patient-days was decreased to 51.7 in 2016. Conclusion IRAB bacteremia causes serious threat in high-risk pediatric patients in PICU. Proactive infection control measures and antimicrobial stewardship are crucial to manage serious IRAB infection in PICU. Disclosures All authors: No reported disclosures.

Lack of Statistical Power

PEDIATRICS ◽  
1987 ◽  
Vol 79 (2) ◽  
pp. 313-314
Author(s):  
JOHN M. PASCOE
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Sample Size ◽  
Pediatric Intensive Care Unit ◽  
Infection Rate ◽  
Nosocomial Infections ◽  
Statistical Power ◽  
Pediatric Intensive Care ◽  
Negative Trial

To the Editor.— Dr Donowitz described an interesting research project in which the efficacy of overgown use in the prevention of pediatric intensive care unit nosocomial infection was examined.1 He concludes that "overgowns were an expensive and ineffective method of preventing or decreasing nosocomial infections."1 Although Dr Donowitz may be correct, his inattention to sample size and statistical power in this negative trial makes his argument less than compelling. Given the nosocomial "base rate" of about 10% without gowns, the detection of an infection rate difference of 50% between the nongown and gown subgroups (α = .05, β = .2) would require a sample size of about 500 in each subgroup.2

Evaluating Central Venous Catheter Care in a Pediatric Intensive Care Unit

2009 ◽  
Vol 18 (6) ◽  
pp. 514-520 ◽  
Author(s):  
Carol Hatler ◽  
Linda Buckwald ◽  
Zoraida Salas-Allison ◽  
Cathleen Murphy-Taylor
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Central Venous Catheter ◽  
Infection Control ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Venous Catheter ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Central Catheters

Background Catheter-related bloodstream infection remains an important health problem for hospitalized children. Although placement of a central venous catheter is a life-saving intervention for critically ill children, these same central catheters are a potential source of infection. Objectives Few studies that directly address care of central venous catheters for children in intensive care units have been reported. This evaluation was designed to describe the extent of evidence-based practices for care of insertion sites of central venous catheters in the pediatric intensive care unit of an urban tertiary care center. Another goal was to determine the influence of 2 different regimens for dressing changes on rates of catheter-related bloodstream infections and costs. Methods A convenience sample and an exploratory design were used to collect data in 2 phases, including 30 days to establish baseline information and 30 days each during which patients received dressing care for a central venous catheter with a transparent dressing alone and with a transparent dressing plus a chlorhexidine-impregnated dressing. Nurses also participated in a survey of knowledge about infection control practices related to central catheters. Results Few differences were found between the transparent dressing alone and a chlorhexidine-impregnated dressing plus the transparent dressing. A serendipitous finding was the number of times that central catheters were accessed daily. Conclusions The results of this project suggest that infection control efforts may be most appropriately focused on processes rather than on products.

scholarly journals Healthcare-associated infections in a newly opened pediatric intensive care unit in Turkey: Results of four-year surveillance

2016 ◽  
Vol 10 (03) ◽  
pp. 254-259 ◽  
Author(s):  
Serkan Atici ◽  
Ahmet Soysal ◽  
Eda Kepenekli Kadayifci ◽  
Ayşe Karaaslan ◽  
Gülşen Akkoç ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Pediatric Intensive Care Unit ◽  
Methicillin Resistance ◽  
Pediatric Intensive Care ◽  
Incidence Density ◽  
Healthcare Associated Infections ◽  
Healthcare Associated ◽  
Klebsiella Spp

Introduction: Healthcare-associated infections (HAIs) are important causes of morbidity and mortality, especially in critically ill patients in intensive care units. The aim of this study was to assess the rate and distribution of HAIs, pathogens, and antimicrobial susceptibility patterns in a newly opened pediatric intensive care unit (PICU). Methodology: The infection control team detected and recorded HAI cases according to the Centers for Disease Control and Prevention’s criteria in the PICU of Marmara University Pendik Training and Research Hospital over a four-year period following its opening. Laboratory-based HAIs surveillance was performed prospectively from 1 January 2011 to 30 November 2014. Results: During the study period, 1,007 patients hospitalized in the PICU and 224 HAIs were identified. The overall HAI rate was 22.24%, and the incidence density was 20.71 per 1,000 patient-days. The most commonly observed HAIs were bloodstream infection (35.7%), pneumonia (21.4%), and urinary tract infection (20.5%), and the three most common HAI pathogens were Klebsiella spp. (19.4%), Pseudomonas aeruginosa (13.8%), and Acinetobacter baumanii (12%). Methicillin resistance was detected in 78% of coagulase-negative Staphylococcus. Presence of extended-spectrum beta-lactamases was determined in 45% and 54% of Klebsiella spp. strains and Escherichia coli isolates, respectively. Conclusions: Our rate of HAIs is higher than the mean rates reported in PICU studies from developed countries. Active surveillance studies of HAIs is an essential component of infection control, which may contribute to improving preventive strategies in developing countries.

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