Health care-associated infections among critically ill children in the US, 2007-2012

Stephen W. Patrick, Alison T se Kawai, Ken Kleinman, Robert Jin, Louise Vaz, Charlene Gay, William Kassler, Don Goldmann, Grace M. Lee

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

BACKGROUND: Health care-associated infections (HAIs) are harmful and costly and can result in substantial morbidity for hospitalized children; however, little is known about national trends in HAIs in neonatal and pediatric populations. Our objective was to determine the incidence of HAIs among a large sample of hospitals in the United States caring for critically ill children from 2007 to 2012.

METHODS: In this cohort study, we included NICUs and PICUs located in hospitals reporting data to the Centers for Disease Control and Prevention's National Healthcare Safety Network for central line-associated bloodstream infections (CLABSIs), ventilator-associated pneumonias, and catheter-associated urinary tract infections. We used a time-series design to evaluate changes in HAI rates.

RESULTS: A total of 173 US hospitals provided data from NICUs, and 64 provided data from PICUs. From 2007 to 2012, rates of CLABSIs decreased in NICUs from 4.9 to 1.5 per 1000 central-line days (incidence rate ratio (IRR) per quarter = 0.96, 95% confidence interval 0.94-0.97) and in PICUs from 4.7 to 1.0 per 1000 central-line days (IRR per quarter = 0.96 [0.94-0.98]). Rates of ventilator-associated pneumonias decreased in NICUs from 1.6 to 0.6 per 1000 ventilator days (IRR per quarter = 0.97 [0.93-0.99]) and PICUs from 1.9 to 0.7 per 1000 ventilator-days (IRR per quarter = 0.95 [0.92-0.98]). Rates of catheter-associated urinary tract infections did not change significantly in PICUs.

CONCLUSIONS: Between 2007 and 2012 there were substantial reductions in HAIs among hospitalized neonates and children.

Original languageEnglish (US)
Pages (from-to)705-712
Number of pages8
JournalPediatrics
Volume134
Issue number4
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

Fingerprint

Cross Infection
Critical Illness
Incidence
Ventilator-Associated Pneumonia
Catheter-Related Infections
Hospitalized Child
Mechanical Ventilators
Urinary Tract Infections
Centers for Disease Control and Prevention (U.S.)
Infection
Cohort Studies
Research Design
Newborn Infant
Confidence Intervals
Pediatrics
Morbidity
Delivery of Health Care
Safety
Population

Keywords

  • catheter-associated urinary tract infections
  • central line–associated bloodstream infections
  • health care–associated infections
  • Medicaid
  • ventilator-associated pneumonia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Patrick, S. W., Kawai, A. T. S., Kleinman, K., Jin, R., Vaz, L., Gay, C., ... Lee, G. M. (2014). Health care-associated infections among critically ill children in the US, 2007-2012. Pediatrics, 134(4), 705-712. https://doi.org/10.1542/peds.2014-0613

Health care-associated infections among critically ill children in the US, 2007-2012. / Patrick, Stephen W.; Kawai, Alison T se; Kleinman, Ken; Jin, Robert; Vaz, Louise; Gay, Charlene; Kassler, William; Goldmann, Don; Lee, Grace M.

In: Pediatrics, Vol. 134, No. 4, 01.10.2014, p. 705-712.

Research output: Contribution to journalArticle

Patrick, SW, Kawai, ATS, Kleinman, K, Jin, R, Vaz, L, Gay, C, Kassler, W, Goldmann, D & Lee, GM 2014, 'Health care-associated infections among critically ill children in the US, 2007-2012', Pediatrics, vol. 134, no. 4, pp. 705-712. https://doi.org/10.1542/peds.2014-0613
Patrick, Stephen W. ; Kawai, Alison T se ; Kleinman, Ken ; Jin, Robert ; Vaz, Louise ; Gay, Charlene ; Kassler, William ; Goldmann, Don ; Lee, Grace M. / Health care-associated infections among critically ill children in the US, 2007-2012. In: Pediatrics. 2014 ; Vol. 134, No. 4. pp. 705-712.
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AU - Patrick, Stephen W.

AU - Kawai, Alison T se

AU - Kleinman, Ken

AU - Jin, Robert

AU - Vaz, Louise

AU - Gay, Charlene

AU - Kassler, William

AU - Goldmann, Don

AU - Lee, Grace M.

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N2 - BACKGROUND: Health care-associated infections (HAIs) are harmful and costly and can result in substantial morbidity for hospitalized children; however, little is known about national trends in HAIs in neonatal and pediatric populations. Our objective was to determine the incidence of HAIs among a large sample of hospitals in the United States caring for critically ill children from 2007 to 2012.METHODS: In this cohort study, we included NICUs and PICUs located in hospitals reporting data to the Centers for Disease Control and Prevention's National Healthcare Safety Network for central line-associated bloodstream infections (CLABSIs), ventilator-associated pneumonias, and catheter-associated urinary tract infections. We used a time-series design to evaluate changes in HAI rates.RESULTS: A total of 173 US hospitals provided data from NICUs, and 64 provided data from PICUs. From 2007 to 2012, rates of CLABSIs decreased in NICUs from 4.9 to 1.5 per 1000 central-line days (incidence rate ratio (IRR) per quarter = 0.96, 95% confidence interval 0.94-0.97) and in PICUs from 4.7 to 1.0 per 1000 central-line days (IRR per quarter = 0.96 [0.94-0.98]). Rates of ventilator-associated pneumonias decreased in NICUs from 1.6 to 0.6 per 1000 ventilator days (IRR per quarter = 0.97 [0.93-0.99]) and PICUs from 1.9 to 0.7 per 1000 ventilator-days (IRR per quarter = 0.95 [0.92-0.98]). Rates of catheter-associated urinary tract infections did not change significantly in PICUs.CONCLUSIONS: Between 2007 and 2012 there were substantial reductions in HAIs among hospitalized neonates and children.

AB - BACKGROUND: Health care-associated infections (HAIs) are harmful and costly and can result in substantial morbidity for hospitalized children; however, little is known about national trends in HAIs in neonatal and pediatric populations. Our objective was to determine the incidence of HAIs among a large sample of hospitals in the United States caring for critically ill children from 2007 to 2012.METHODS: In this cohort study, we included NICUs and PICUs located in hospitals reporting data to the Centers for Disease Control and Prevention's National Healthcare Safety Network for central line-associated bloodstream infections (CLABSIs), ventilator-associated pneumonias, and catheter-associated urinary tract infections. We used a time-series design to evaluate changes in HAI rates.RESULTS: A total of 173 US hospitals provided data from NICUs, and 64 provided data from PICUs. From 2007 to 2012, rates of CLABSIs decreased in NICUs from 4.9 to 1.5 per 1000 central-line days (incidence rate ratio (IRR) per quarter = 0.96, 95% confidence interval 0.94-0.97) and in PICUs from 4.7 to 1.0 per 1000 central-line days (IRR per quarter = 0.96 [0.94-0.98]). Rates of ventilator-associated pneumonias decreased in NICUs from 1.6 to 0.6 per 1000 ventilator days (IRR per quarter = 0.97 [0.93-0.99]) and PICUs from 1.9 to 0.7 per 1000 ventilator-days (IRR per quarter = 0.95 [0.92-0.98]). Rates of catheter-associated urinary tract infections did not change significantly in PICUs.CONCLUSIONS: Between 2007 and 2012 there were substantial reductions in HAIs among hospitalized neonates and children.

KW - catheter-associated urinary tract infections

KW - central line–associated bloodstream infections

KW - health care–associated infections

KW - Medicaid

KW - ventilator-associated pneumonia

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