Health care-associated infections and mortality in critically ill pediatric patients

Abstract

Healthcare-Associated Infections (HAIs) in Pediatric Intensive Care Units (PICUs) are a global problem. Mortality due to HAIs is 10% and may be higher in developing countries.

Objectives: To determine the association between HAIs and mortality in pediatric patients admitted to the Intensive Care Unit in a tertiary Hospital.

Patients and Method: Observational retrospective cohort study. Demographic and clinical variables (diagnosis, origin area, length of stay, mortality), as well as infectious variables (type of microorganism, type of HAI, multidrug resistance), were analyzed. The relationship between mortality and the development of HAI was assessed using the Chi-square test. A logistic regression model was used to evaluate other explanatory variables of mortality.

Results: 363 patients were studied, 23.7% of them were diagnosed with HAIs. The median age was 3 years (IQR: 1-9) and 51.2% were male. The most frequent HAI was ventilator-associated pneumonia (36%). Overall mortality was 10.7%, with a significant difference between groups with and without HAIs (18.4% vs. 8.7%, respectively; p= 0.01). The predictive mortality model concluded an association between mortality and multidrug-resistant (MDR) bacteria (OR: 8.66; 95% CI 2.01-37.21; p= 0.004). This group had a longer stay in the PICU (18 vs. 6 days; p=<0.001).

Conclusions: For patients admitted to the PICU at Hospital Baca Ortiz in 2022, the presence of MDR bacteria was associated with increased mortality and length of stay.