Incidencia de bacteriemia y neumonía nosocomial en una unidad de pediatría

Résumé 0

Objective. To determine the incidence of catheter-relatedbacteremia and ventilator-associated pneumonia in childrenadmitted to a secondary care hospital. Material and Methods.A prospective active surveillance system was conductedfrom January 1999 to June 2000, at the Hospital Generalof Instituto Mexicano del Seguro Social in Durango, Mexico.Daily visits to the pediatric ward were conducted to detectepisodes of bacteremia and pneumonia, according to theOfficial Mexican Norm. Hospitalized patients under mechanicalventilation and/or with a central venous catheter, werefollowed from the first day of exposure, until a nosocomialinfection was detected, or until the invasive device was removed.Blood and tracheal aspirate cultures were obtainedfrom all exposed patients. Incidence rates with 95% confidenceintervals were calculated for ventilator-associatedpneumonia and bacteremia/sepsis per 1000 exposure days.Also, the monthly infection rate is presented for days ofexposure, using statistical control graphs. Results. A totalof 47 episodes of bacteremia/sepsis and 44 of ventilatorassociated pneumonia were recorded. The incidence rateof pneumonia and bacteremia/sepsis was 28 and 26 casesrespectively, per 1000 days of exposure to and invasive device.The gram-positive rods (61.11%) were more commonthan the gram negative rods (38.88%). Conclusions. Themost striking finding of this study was the higher incidence of these two nosocomial infections in children, as comparedto that reported elsewhere. These findings call for preventivestrategies and guidelines for handling intravenous cathetersand mechanical ventilation in Mexico. The Englishversion of this paper is available at: http://www.insp.mx/salud/index.html