Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs
Healthcare-associated infections related to device use (DA-HAIs) are a serious public health problem since they increase mortality, length of hospital stay and healthcare costs. We performed a multicenter, prospective study analyzing critically ill pediatric patients admitted to 26 Spanish pediatric...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Children |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9067/9/11/1669 |
| _version_ | 1797468742820560896 |
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| author | Elena Fresán-Ruiz Gemma Pons-Tomás Juan Carlos de Carlos-Vicente Amaya Bustinza-Arriortua María Slocker-Barrio Sylvia Belda-Hofheinz Montserrat Nieto-Moro Sonia María Uriona-Tuma Laia Pinós-Tella Elvira Morteruel-Arizcuren Cristina Schuffelmann Yolanda Peña-López Sara Bobillo-Pérez Iolanda Jordan on behalf of the Pediatric-ENVIN-HELICS Study Group |
| author_facet | Elena Fresán-Ruiz Gemma Pons-Tomás Juan Carlos de Carlos-Vicente Amaya Bustinza-Arriortua María Slocker-Barrio Sylvia Belda-Hofheinz Montserrat Nieto-Moro Sonia María Uriona-Tuma Laia Pinós-Tella Elvira Morteruel-Arizcuren Cristina Schuffelmann Yolanda Peña-López Sara Bobillo-Pérez Iolanda Jordan on behalf of the Pediatric-ENVIN-HELICS Study Group |
| author_sort | Elena Fresán-Ruiz |
| collection | DOAJ |
| description | Healthcare-associated infections related to device use (DA-HAIs) are a serious public health problem since they increase mortality, length of hospital stay and healthcare costs. We performed a multicenter, prospective study analyzing critically ill pediatric patients admitted to 26 Spanish pediatric intensive care units (PICUs) over a 3-month period each year from 2014 to 2019. To make comparisons and evaluate the influence of HAI Zero Bundles (care bundles that intend to reduce the DA-HAI rates to zero) on PICU HAI rates, the analysis was divided into two periods: 2014–2016 and 2017–2019 (once most of the units had incorporated all the Zero Bundles). A total of 11,260 pediatric patients were included. There were 390 episodes of HAIs in 317 patients and the overall rate of HAIs was 6.3 per 1000 patient days. The DA-HAI distribution was: 2.46/1000 CVC days for central-line-associated bloodstream infections (CLABSIs), 5.75/1000 MV days for ventilator-associated pneumonia (VAP) and 3.6/1000 UC days for catheter-associated urinary tract infections (CAUTIs). Comparing the two periods, the HAI rate decreased (<i>p</i> = 0.061) as well as HAI episodes (<i>p</i> = 0.011). The results demonstrate that exposure to devices constitutes an extrinsic risk factor for acquiring HAIs. The multivariate analysis highlights previous bacterial colonization by multidrug-resistant (MDR) bacteria as the most important extrinsic risk factor for HAIs (OR 20.4; 95%CI 14.3–29.1). In conclusion, HAI Zero Bundles have been shown to decrease HAI rates, and the focus should be on the prompt removal of devices, especially in children with important intrinsic risk factors. |
| first_indexed | 2024-03-09T19:10:43Z |
| format | Article |
| id | doaj.art-d3245542be6f4abda73174db6a83da4a |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-09T19:10:43Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-d3245542be6f4abda73174db6a83da4a2023-11-24T04:11:56ZengMDPI AGChildren2227-90672022-10-01911166910.3390/children9111669Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUsElena Fresán-Ruiz0Gemma Pons-Tomás1Juan Carlos de Carlos-Vicente2Amaya Bustinza-Arriortua3María Slocker-Barrio4Sylvia Belda-Hofheinz5Montserrat Nieto-Moro6Sonia María Uriona-Tuma7Laia Pinós-Tella8Elvira Morteruel-Arizcuren9Cristina Schuffelmann10Yolanda Peña-López11Sara Bobillo-Pérez12Iolanda Jordan13on behalf of the Pediatric-ENVIN-HELICS Study GroupPediatric Intensive Care Unit, Hospital Sant Joan de Déu, 08950 Barcelona, SpainPediatrics Department, Hospital Sant Joan de Déu, 08950 Barcelona, SpainPediatric Intensive Care Unit, Hospital Son Espases, 07120 Palma de Mallorca, SpainPediatric Intensive Care Unit, Hospital Gregorio Marañón, 28007 Madrid, SpainPediatric Intensive Care Unit, Hospital Gregorio Marañón, 28007 Madrid, SpainPediatric Intensive Care Unit, Hospital 12 de Octubre, 28041 Madrid, SpainPediatric Intensive Care Unit, Hospital Niño Jesús, 28009 Madrid, SpainPreventive Medicine and Public Health, ENVIN-HELICS Registry Administration, Hospital Vall d’Hebron, 08035 Barcelona, SpainPreventive Medicine and Public Health, ENVIN-HELICS Registry Administration, Hospital Vall d’Hebron, 08035 Barcelona, SpainPediatric Intensive Care Unit, Hospital de Cruces, 48903 Bilbao, SpainPediatric Intensive Care Unit, Hospital La Paz, 28046 Madrid, SpainPediatric Intensive Care Unit, Hospital Materno-Infantil Vall d’Hebron, 08035 Barcelona, SpainPediatric Intensive Care Unit, Hospital Sant Joan de Déu, 08950 Barcelona, SpainPediatric Intensive Care Unit, Hospital Sant Joan de Déu, 08950 Barcelona, SpainHealthcare-associated infections related to device use (DA-HAIs) are a serious public health problem since they increase mortality, length of hospital stay and healthcare costs. We performed a multicenter, prospective study analyzing critically ill pediatric patients admitted to 26 Spanish pediatric intensive care units (PICUs) over a 3-month period each year from 2014 to 2019. To make comparisons and evaluate the influence of HAI Zero Bundles (care bundles that intend to reduce the DA-HAI rates to zero) on PICU HAI rates, the analysis was divided into two periods: 2014–2016 and 2017–2019 (once most of the units had incorporated all the Zero Bundles). A total of 11,260 pediatric patients were included. There were 390 episodes of HAIs in 317 patients and the overall rate of HAIs was 6.3 per 1000 patient days. The DA-HAI distribution was: 2.46/1000 CVC days for central-line-associated bloodstream infections (CLABSIs), 5.75/1000 MV days for ventilator-associated pneumonia (VAP) and 3.6/1000 UC days for catheter-associated urinary tract infections (CAUTIs). Comparing the two periods, the HAI rate decreased (<i>p</i> = 0.061) as well as HAI episodes (<i>p</i> = 0.011). The results demonstrate that exposure to devices constitutes an extrinsic risk factor for acquiring HAIs. The multivariate analysis highlights previous bacterial colonization by multidrug-resistant (MDR) bacteria as the most important extrinsic risk factor for HAIs (OR 20.4; 95%CI 14.3–29.1). In conclusion, HAI Zero Bundles have been shown to decrease HAI rates, and the focus should be on the prompt removal of devices, especially in children with important intrinsic risk factors.https://www.mdpi.com/2227-9067/9/11/1669PICUSpainchildrenhealthcare-associated infectionsdevice-associated infectionsCLABSI |
| spellingShingle | Elena Fresán-Ruiz Gemma Pons-Tomás Juan Carlos de Carlos-Vicente Amaya Bustinza-Arriortua María Slocker-Barrio Sylvia Belda-Hofheinz Montserrat Nieto-Moro Sonia María Uriona-Tuma Laia Pinós-Tella Elvira Morteruel-Arizcuren Cristina Schuffelmann Yolanda Peña-López Sara Bobillo-Pérez Iolanda Jordan on behalf of the Pediatric-ENVIN-HELICS Study Group Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs Children PICU Spain children healthcare-associated infections device-associated infections CLABSI |
| title | Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs |
| title_full | Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs |
| title_fullStr | Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs |
| title_full_unstemmed | Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs |
| title_short | Device Exposure and Patient Risk Factors’ Impact on the Healthcare-Associated Infection Rates in PICUs |
| title_sort | device exposure and patient risk factors impact on the healthcare associated infection rates in picus |
| topic | PICU Spain children healthcare-associated infections device-associated infections CLABSI |
| url | https://www.mdpi.com/2227-9067/9/11/1669 |
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