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Çocuklarda Nozokomiyal Enfeksiyonlar İçin Risk Faktörleri

Yıl 2021, , 622 - 626, 17.09.2021
https://doi.org/10.16899/jcm.927301

Öz

ABSTRACT
Aim: To determine the frequency of nosocomial infections developed within a year in patients admitted to a tertiary pediatric hospital.
Materials and Method: The patients who have been hospitalized at Dr Sami Ulus Children Hospital in a one-year period between February 1996 - February 1997 and diagnosed ‘nosocomial infection’ during their follow up were included in this study. The ‘nosocomial infection’ diagnosis used was based on Center for Disease Control (CDC) diagnostics criteria. Clinical findings were recorded besides laboratory and imaging data.
Results
In one-year period under consideration, a total number of 3420 patients were hospitalized. Nosocomial infection was detected in 9.1% (n=311) of these patients. 28.6% (n=89) of them were acute gastroenteritis, 23.4% (n=73) were urinary tract infection and 25.4% (n=79) were sepsis. The most common etiologic agents were K. pneumoniae (%40.3), Salmonella spp. (%43.0) and E. coli (%13.4). 77.8% of the patients with nosocomial infection were younger than one year old. In patients with urinary tract infection, 28.7% had urethral catheterization. Nosocomial infection was being observed after 16.9±10 days of hospitalization. 12.2% (n=38) of the patients with nosocomial infection have died. Inadequacy of professional staff, insufficient number of nurses per patient and failures in hand washing were thought to be the risk factors in the development of nosocomial infection.
Conclusion: Nosocomial infection is an important cause for mortality and morbidity in pediatrics clinics. The most important steps in the efforts to decrease nosocomial infection frequency may be listed as the surveillance, detection of the problems and taking corresponding precautions to take the nosocomial infection under control.
Keywords: Nosocomial infection; Child; Risk factors.

ÖZ
Amaç: Üçüncü basamak çocuk hastanesine bir yıl içinde başvuran hastalarda gelişen hastane enfeksiyonlarının sıklığını belirlemek.
Gereç ve Yöntem: Dr. Sami Ulus Çocuk Hastanesi'nde Şubat 1996 - Şubat 1997 tarihleri arasındaki bir yıllık sürede, yatarken ve takiplerinde 'hastane enfeksiyonu' tanısı alan hastalar çalışmaya dahil edildi. Kullanılan "nozokomiyal enfeksiyon" tanısında, Center for Disease Control (CDC) tanı kriterleri temel alındı. Laboratuvar ve görüntüleme verilerinin yanı sıra klinik bulgular da kaydedildi.
Sonuçlar
İncelenen bir yıllık dönemde toplam 3420 hasta hastaneye yatırıldı. Bu hastaların %9,1'inde (n = 311) hastane enfeksiyonu tespit edildi. Bunların %28,6'sı (n = 89) akut gastroenterit, %23,4'ü (n = 73) idrar yolu enfeksiyonu ve %25,4'ü (n = 79) sepsis idi. En sık karşılaşılan etiyolojik ajanlar K. pneumoniae (%40,3), Salmonella spp. (%43,0) ve E. coli (%13,4) idi. Hastane enfeksiyonu olan hastaların %77,8'i bir yaşından küçüktü. İdrar yolu enfeksiyonu olan hastaların %28,7'sinde üretral kateterizasyon vardı. Hastanede yatışın 16.9 ± 10 gününde nozokomiyal enfeksiyon geliştiği görüldü. Hastane enfeksiyonu olan hastaların %12,2'si (n = 38) kaybedildi. Uzman personel yetersizliği, hasta başına düşen hemşire sayısı ve yeterli el yıkamamanın nozokomiyal enfeksiyon gelişiminde risk faktörleri olduğu düşünülmüştür.
Sonuç: Hastane enfeksiyonu pediatri kliniklerinde önemli bir mortalite ve morbidite nedenidir. Hastane enfeksiyonu sıklığını azaltma çabalarında en önemli adımlar, nozokomiyal enfeksiyonun kontrol altına alınması için sürveyans, sorunların tespiti ve buna uygun önlemlerin alınması olarak sıralanabilir.
Anahtar Kelimeler: Nozokomiyal enfeksiyon, Çocuk, Risk faktörleri.

Kaynakça

  • 1. Horan TC, Gaynes RP, Jarwis W. CDC definations of nosocomial surgical site infections. Infection Control Hospital Epidemiology 1992;13(2):606-8.
  • 2. Burke JP. Infection control - a problem for patient safety. New England Journal of Medicine. 2003;1(348):651-56.
  • 3. Harris J, A.S. Pediatric Nosocomial Infections: Children Are Not Little Adults. Journal of Hospital Infection 1997; 18(2):739-42.
  • 4. Mühlemann K, Franzini C, Aebi C, et al. Prevalence of nosocomial infections in Swiss children's hospitals. IInfection Control & Hospital Epidemiology 2004;9(25):765-71.
  • 5. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for Prevention of Surgical Site Infection 1999. Centers for Disease and Prevention, (CDC). Hospital Infection Control Practices Advisory Commitee. Am J Infect Control 1999; 27(1): 97-132.
  • 6. Raymond J, Aujard Y, the European Study Group. Nosocomial infections in pediatrics: A European , multicenter prospective study. Infect Control Hosp Epidemiol 2002; 21: 260-3.
  • 7. Richards MJ, Edwards JR, Culver DH, Caynes RP. Nosocomial Infections in Combined Medical-Surgical Intensive Care Units in The United States. Infect Control Hosp Epidemiol 2000; 21(1): 510-5.
  • 8. El-Nawawy AA, Abd El-Fattah MM, Metwally HA, Barakat SS, Hassan IAOne year study of bacterial and fungal nosocomial infections among patients in pediatric intensive care unit (PICU) in Alexandria.Journal of Tropical Pediatrics 2006;52(3):185-91.
  • 9. Hacımustafaoğlu M, Çelebi S, Tuncer E, Özkaya G, Çakır D, Bozdemir ŞE. Çocuk kliniği ve çocuk yoğun bakım ünitesi hastane enfeksiyonları sıklığı. Çocuk Enfeksiyon Dergisi 2009;3:112-7
  • 10. Maraş H, Somer A, Sütçü M, Acar M, Salman N. Bir Üniversite Hastanesinde Pediyatrik Sağlık Bakımı ile İlişkili Enfeksiyon Sürveyansı: Altı Aylık Prospektif İzlem. Çocuk Dergisi 2015; 15(2):65-73.
  • 11. Larson, E., Horan, T., Terry, B., Landry, S. Study of the Definition of Nosocomial Infections (SDNI). Research Committee of the Association for Practitioners in Infection Control. American Journal of Infection Control. 1991;19(6):259-67.
  • 12. Campins, Vaque J.et al. Nosocomial infections in pediatric patients: A prevalance study in Spanish hospitals. American Journal of Infection Control. 1993;2l (3) :58- 63.
  • 13. Starling CF, Couto M, Pinheiro C. Applying the Centers for Disease control and Prevention and National Nosocomial Surveillance system methods in Brazilian hospitals. American Journal of Infection Control 1997;25:303-306.
  • 14. Özçetin M, Ulaş Saz E, Karapınar B, Özen S, Aydemir Ş, Vardar F. Hastane enfeksiyonları; sıklığı ve risk faktörleri. Çocuk Enfeksiyon Dergisi. 2009;3:49-53.
  • 15. Cavalcante SS, Mota E, Silva LR, Teixeira LF, Cavalcante LB.Risk factors for developing nosocomial infections among pediatric patients. The Pediatric Infectious Disease Journal 2006;25: 438-45.
  • 16. Levy J. The Pediatric Patient, In:Wenzel RP (ed). Revention and Control of Nosocomial Infections. Third edition, Williams & Wilkins, Baltimore, Maryland. 1997; 1039-59.
  • 17. Turgay S. Dr. Sami Ulus Çocuk Hastanesi yenidoğan bakım ünitesinde nozokomiyal infeksiyonlar. Uzmanlık Tezi Ankara-1995)
  • 18. Abramczyk ML, Carvalho WB, Medeiros EA. Nosocomial infection in a pediatric intensive care unit in a developing country. The Brazilian Journal of Infectious Diseases 2003;7:375-80.
  • 19. Zaidi-Jacobson M, Ponce de León-Rosales S, Prospective study of nosocomial infections at a pediatrics unit. Boletín Médico del Hospital Infantil de México (English Edition) 1991; 48:538-43.
  • 20. Lakshmi KS, Jayashree M, Singhi S, Ray P. Study of nosocomial primary bloodstream infections in a pediatric intensive care unit. Journal of Tropical Pediatrics. 2007; 53: 87-92.
  • 21. Thompson P, Greenough A. nosocomial bacterial infections in very low birth weight infants. European Journal of Pediatrics 1992;151:451-454.
  • 22. Patel JC, Mollitt DL. Infections complications in critically injured children. Journal of Pediatric Surgery. 2000;35:1174-8.
  • 23. Kanra G, Arıkan Ö, Ecevit Z. Çocuklarda saptanan nozokomiyal gram negatif bakteriyemi etkenlerinin antibiyotik direnci .Çocuk Sağlığı ve hastalıkları Dergisi 1996;39:473-79.
  • 24. Ertogan F, Arsan S. Yenidoğan Yoğun Bakım Ünitelerinde Nozokomial Sepsis Etkeni Olarak Klebsiella Sorunu. Antibiyotik ve Kemoterapi Derneği Dergisi (ANKEM). 1994;1: 314-318.
  • 25. Ünal S. Hastane İnfeksiyonlarında Direnç Problemi. Antibiyotik ve Kemoterapi Derneği Dergisi (ANKEM) 1996;10:260.
  • 26. Lesky E. Hospital-acquired infections-a historical survey. Hexagon (Roche) 1977;5:1-10.
  • 27. Jolley AE. The Value of Surveillance Cultures on Neonatal Intensive Care Units. The Journal of Hospital Infection 1993; 25:153-9.
  • 28. Yalçın S, Akalın HA, Ünal S. Hacettepe Üniversitesi Hastane İnfeksiyonlarında Antibiyotik Tedavi İlkeleri. Aktüel Tıp Dergisi 1983;1:448.

Risk Factors for Nosocomial Infections in Children

Yıl 2021, , 622 - 626, 17.09.2021
https://doi.org/10.16899/jcm.927301

Öz

ABSTRACT
Aim: To determine the frequency of nosocomial infections developed within a year in patients admitted to a tertiary pediatric hospital.
Materials and Method: The patients who have been hospitalized at Dr Sami Ulus Children Hospital in a one-year period between February 1996 - February 1997 and diagnosed ‘nosocomial infection’ during their follow up were included in this study. The ‘nosocomial infection’ diagnosis used was based on Center for Disease Control (CDC) diagnostics criteria. Clinical findings were recorded besides laboratory and imaging data.
Results
In one-year period under consideration, a total number of 3420 patients were hospitalized. Nosocomial infection was detected in 9.1% (n=311) of these patients. 28.6% (n=89) of them were acute gastroenteritis, 23.4% (n=73) were urinary tract infection and 25.4% (n=79) were sepsis. The most common etiologic agents were K. pneumoniae (%40.3), Salmonella spp. (%43.0) and E. coli (%13.4). 77.8% of the patients with nosocomial infection were younger than one year old. In patients with urinary tract infection, 28.7% had urethral catheterization. Nosocomial infection was being observed after 16.9±10 days of hospitalization. 12.2% (n=38) of the patients with nosocomial infection have died. Inadequacy of professional staff, insufficient number of nurses per patient and failures in hand washing were thought to be the risk factors in the development of nosocomial infection.
Conclusion: Nosocomial infection is an important cause for mortality and morbidity in pediatrics clinics. The most important steps in the efforts to decrease nosocomial infection frequency may be listed as the surveillance, detection of the problems and taking corresponding precautions to take the nosocomial infection under control.

Kaynakça

  • 1. Horan TC, Gaynes RP, Jarwis W. CDC definations of nosocomial surgical site infections. Infection Control Hospital Epidemiology 1992;13(2):606-8.
  • 2. Burke JP. Infection control - a problem for patient safety. New England Journal of Medicine. 2003;1(348):651-56.
  • 3. Harris J, A.S. Pediatric Nosocomial Infections: Children Are Not Little Adults. Journal of Hospital Infection 1997; 18(2):739-42.
  • 4. Mühlemann K, Franzini C, Aebi C, et al. Prevalence of nosocomial infections in Swiss children's hospitals. IInfection Control & Hospital Epidemiology 2004;9(25):765-71.
  • 5. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for Prevention of Surgical Site Infection 1999. Centers for Disease and Prevention, (CDC). Hospital Infection Control Practices Advisory Commitee. Am J Infect Control 1999; 27(1): 97-132.
  • 6. Raymond J, Aujard Y, the European Study Group. Nosocomial infections in pediatrics: A European , multicenter prospective study. Infect Control Hosp Epidemiol 2002; 21: 260-3.
  • 7. Richards MJ, Edwards JR, Culver DH, Caynes RP. Nosocomial Infections in Combined Medical-Surgical Intensive Care Units in The United States. Infect Control Hosp Epidemiol 2000; 21(1): 510-5.
  • 8. El-Nawawy AA, Abd El-Fattah MM, Metwally HA, Barakat SS, Hassan IAOne year study of bacterial and fungal nosocomial infections among patients in pediatric intensive care unit (PICU) in Alexandria.Journal of Tropical Pediatrics 2006;52(3):185-91.
  • 9. Hacımustafaoğlu M, Çelebi S, Tuncer E, Özkaya G, Çakır D, Bozdemir ŞE. Çocuk kliniği ve çocuk yoğun bakım ünitesi hastane enfeksiyonları sıklığı. Çocuk Enfeksiyon Dergisi 2009;3:112-7
  • 10. Maraş H, Somer A, Sütçü M, Acar M, Salman N. Bir Üniversite Hastanesinde Pediyatrik Sağlık Bakımı ile İlişkili Enfeksiyon Sürveyansı: Altı Aylık Prospektif İzlem. Çocuk Dergisi 2015; 15(2):65-73.
  • 11. Larson, E., Horan, T., Terry, B., Landry, S. Study of the Definition of Nosocomial Infections (SDNI). Research Committee of the Association for Practitioners in Infection Control. American Journal of Infection Control. 1991;19(6):259-67.
  • 12. Campins, Vaque J.et al. Nosocomial infections in pediatric patients: A prevalance study in Spanish hospitals. American Journal of Infection Control. 1993;2l (3) :58- 63.
  • 13. Starling CF, Couto M, Pinheiro C. Applying the Centers for Disease control and Prevention and National Nosocomial Surveillance system methods in Brazilian hospitals. American Journal of Infection Control 1997;25:303-306.
  • 14. Özçetin M, Ulaş Saz E, Karapınar B, Özen S, Aydemir Ş, Vardar F. Hastane enfeksiyonları; sıklığı ve risk faktörleri. Çocuk Enfeksiyon Dergisi. 2009;3:49-53.
  • 15. Cavalcante SS, Mota E, Silva LR, Teixeira LF, Cavalcante LB.Risk factors for developing nosocomial infections among pediatric patients. The Pediatric Infectious Disease Journal 2006;25: 438-45.
  • 16. Levy J. The Pediatric Patient, In:Wenzel RP (ed). Revention and Control of Nosocomial Infections. Third edition, Williams & Wilkins, Baltimore, Maryland. 1997; 1039-59.
  • 17. Turgay S. Dr. Sami Ulus Çocuk Hastanesi yenidoğan bakım ünitesinde nozokomiyal infeksiyonlar. Uzmanlık Tezi Ankara-1995)
  • 18. Abramczyk ML, Carvalho WB, Medeiros EA. Nosocomial infection in a pediatric intensive care unit in a developing country. The Brazilian Journal of Infectious Diseases 2003;7:375-80.
  • 19. Zaidi-Jacobson M, Ponce de León-Rosales S, Prospective study of nosocomial infections at a pediatrics unit. Boletín Médico del Hospital Infantil de México (English Edition) 1991; 48:538-43.
  • 20. Lakshmi KS, Jayashree M, Singhi S, Ray P. Study of nosocomial primary bloodstream infections in a pediatric intensive care unit. Journal of Tropical Pediatrics. 2007; 53: 87-92.
  • 21. Thompson P, Greenough A. nosocomial bacterial infections in very low birth weight infants. European Journal of Pediatrics 1992;151:451-454.
  • 22. Patel JC, Mollitt DL. Infections complications in critically injured children. Journal of Pediatric Surgery. 2000;35:1174-8.
  • 23. Kanra G, Arıkan Ö, Ecevit Z. Çocuklarda saptanan nozokomiyal gram negatif bakteriyemi etkenlerinin antibiyotik direnci .Çocuk Sağlığı ve hastalıkları Dergisi 1996;39:473-79.
  • 24. Ertogan F, Arsan S. Yenidoğan Yoğun Bakım Ünitelerinde Nozokomial Sepsis Etkeni Olarak Klebsiella Sorunu. Antibiyotik ve Kemoterapi Derneği Dergisi (ANKEM). 1994;1: 314-318.
  • 25. Ünal S. Hastane İnfeksiyonlarında Direnç Problemi. Antibiyotik ve Kemoterapi Derneği Dergisi (ANKEM) 1996;10:260.
  • 26. Lesky E. Hospital-acquired infections-a historical survey. Hexagon (Roche) 1977;5:1-10.
  • 27. Jolley AE. The Value of Surveillance Cultures on Neonatal Intensive Care Units. The Journal of Hospital Infection 1993; 25:153-9.
  • 28. Yalçın S, Akalın HA, Ünal S. Hacettepe Üniversitesi Hastane İnfeksiyonlarında Antibiyotik Tedavi İlkeleri. Aktüel Tıp Dergisi 1983;1:448.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Araştırma
Yazarlar

Tülin Çataklı 0000-0001-6670-1078

Aysel Yöney 0000-0003-0335-9900

Yayımlanma Tarihi 17 Eylül 2021
Kabul Tarihi 24 Mayıs 2021
Yayımlandığı Sayı Yıl 2021

Kaynak Göster

AMA Çataklı T, Yöney A. Risk Factors for Nosocomial Infections in Children. J Contemp Med. Eylül 2021;11(5):622-626. doi:10.16899/jcm.927301