REPEATED PREVALENCE SURVEYS OF PEDIATRIC HOSPITAL-ACQUIRED INFECTION

Hospital-acquired infection (HAI) results in an enormous burden of exc ess morbidity, mortality and cost in both adults and children. Monitor ing HAI is difficult, especially with limited resources, but it is vit al if infection control measures are to be appropriately implemented a nd assessed. Cross-sectional prevalence surveys, repeated every six mo nths, have been used effectively to monitor HAI in adults, but this te chnique has not been previously employed in the paediatric population. We performed prevalence surveys of HAI on a single day once every six months for five years, using a standardized questionnaire. Of the 162 3 inpatients surveyed, 125 (7.7%) had HAI and 352 (21%) had community- acquired infection. In those with HAI, central-line infections, pneumo nia, and wound infections predominated. A hospital stay of greater tha n seven days was associated with a sixfold increase in the risk of HAI . In addition, admission to a paediatric or neonatal intensive care un it, the presence of a urinary or vascular catheter, the presence of an endotracheal tube, immunosuppression and recent surgery were all asso ciated with a significantly increased risk of HAI. In contrast to othe r studies, younger children were not at increased risk of HAI; admissi on to the neonatal unit, rather than age per se, was associated with i ncreased risk. We conclude that repeated prevalence surveys enable sim ple and cost-effective assessment of HAI, facilitating appropriate inf ection control interventions. They should be used more widely in the p aediatric setting.