Health-care-associated infections in neonates, children, and adolescents: an analysis of paediatric data from the European Centre for Disease Prevention and Control point-prevalence survey

Walter Zingg, Susan Hopkins, Angèle Gayet-Ageron, Alison Holmes, Mike Sharland, Carl Suetens, Maria Almeida, Jolanta Asembergiene, Michael A. Borg, Ana Budimir, Shona Cairns, Robert Cunney, Aleksander Deptula, Pilar Gallego Berciano, Olafur Gudlaugsson, Avgi Hadjiloucas, Naïma Hammami, Wendy Harrison, Elisabeth Heisbourg, Jana KolmanFlora Kontopidou, Brian Kristensen, Outi Lyytikäinen, Pille Märtin, Gerry McIlvenny, Maria Luisa Moro, Brar Piening, Elisabeth Presterl, Roxana Serban, Emma Smid, Nina K. Sorknes, Maria Stefkovicova, Inese Sviestina, Rita Szabo, Hana Tkadlecova, Rossitza Vatcheva-Dobrevska, Delphine VerjatTrannoy

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68 Citations (Scopus)

Abstract

Background In 2011–12, the European Centre for Disease Prevention and Control (ECDC) held the first Europe-wide point-prevalence survey of health-care-associated infections in acute care hospitals. We analysed paediatric data from this survey, aiming to calculate the prevalence and type of health-care-associated infections in children and adolescents in Europe and to determine risk factors for infection in this population. Methods Point-prevalence surveys took place from May, 2011, to November, 2012, in 1149 hospitals in EU Member States, Iceland, Norway, and Croatia. Patients present on the ward at 0800 h on the day of the survey and who were not discharged at the time of the survey were included. Data were collected by locally trained health-care workers according to patient-based or unit-based protocols. We extracted data from the ECDC database for all paediatric patients (age 0–18 years). We report adjusted prevalence for health-care-associated infections by clustering at the hospital and country level. We also calculated risk factors for development of health-care-associated infections with use of a generalised linear mixed-effects model. Findings We analysed data for 17 273 children and adolescents from 29 countries. 770 health-care-associated infections were reported in 726 children and adolescents, corresponding to a prevalence of 4·2% (95% CI 3·7–4·8). Bloodstream infections were the most common type of infection (343 [45%] infections), followed by lower respiratory tract infections (171 [22%]), gastrointestinal infections (64 [8%]), eye, ear, nose, and throat infections (55 [7%]), urinary tract infections (37 [5%]), and surgical-site infections (34 [4%]). The prevalence of infections was highest in paediatric intensive care units (15·5%, 95% CI 11·6–20·3) and neonatal intensive care units (10·7%, 9·0–12·7). Independent risk factors for infection were age younger than 12 months, fatal disease (via ultimately and rapidly fatal McCabe scores), prolonged length of stay, and the use of invasive medical devices. 392 microorganisms were reported for 342 health-care-associated infections, with Enterobacteriaceae being the most frequently found (113 [15%]). Interpretation Infection prevention and control strategies in children should focus on prevention of bloodstream infections, particularly among neonates and infants. Funding None.

Original languageEnglish
Pages (from-to)381-389
Number of pages9
JournalThe Lancet Infectious Diseases
Volume17
Issue number4
DOIs
Publication statusPublished - 1 Apr 2017

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