1407 Incidence and Risk Factors for Healthcare-Associated Pneumonia in a Pediatric Intensive Care Unit

Abstract

Backgorund and aims: Healthcare-associated pneumonia (HCAP) is one of the top two causes of healthcare associated infections (HAI) in pediatric intensive care units (PICU). This study aimed to determine the incidence and risk factors for HCAP in a PICU.

Methods: prospective cohort study in a paediatric intensive care unit with 16 medical and surgical beds in a tertiary teaching hospital in Recife, northeast Brazil. Patients aged less than 18 years were consecutively enrolled between January 2005 and June 2006. Newborns and patients admitted for surveillance and those staying for less than 24 hours were excluded. Patients were followed up daily throughout the stay and until 48 h after discharge from the unit.

Results: There were 765 eligible admissions. HCAP occurred in 51 (6.7%) patients, with an incidence density of 13.1 episodes/1000 patient-days. There were 366 (47.8%) patients on mechanical ventilation, of whom 39 (10.7%) presented with ventilator-associated pneumonia, with an incidence density of 27.1/1000 days on ventilation. Longer stay on ventilation (OR=1.04 IC95=1.01-1.08), use of gastric tube (OR=2.88 IC95=1.41-5.87) and of sedatives/analgesics (OR=2.45 IC95=1.27-4.72) were identified as independent risk factors for healthcare-associated pneumonia.

Conclusions: identification of independent predictors of healthcare-associated pneumonia may inform preventive measures. Strategies to optimize use of sedatives/analgesics, reduce the use of gastric tubes and the time on ventilation should be considered for inclusion in future intervention studies.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account

Continue with Google

Continue with ORCiD