Risk factors for intranosocomial bacterial infections in children. A case-control study.

With the objective to identify independent risk factors associated with the development of nosocomial bacteremia, we have performed a prospective, exp loratory, case-control study. All non-neutropenic children with nosocomial bacteremia admitted during a seven-month period were eligible. All children non-neutropenic without nosocomial bacteremia were eligible as controls. T he incidence of bacteremia in the study population was 11.3/1000 admissions . Ninety one cases and ninety nine controls were analyzed. In 46% of patien ts clinical foci were detected. The catheter-related infection was the most frequently founded. Staphylococcus spp coagulase negative, Staphylococcus aureus(17) and Klebsiella pneumoniae(12) were the microorganisms more frequ ently isolated. Multivariate analysis identified five risk factors independ ently associated with nosocomial bacteremia: admission outside of Intensive Care Units (ICU) (OR: 8.14, 2.60-25.5), previous antibiotic treatment (OR: 5.02, 2.18-11.5), invasive procedures (OR: 5.35, 1.70-16.8), without surge ry (OR: 2.99, 1.37-6.52) and the presence of central Venous lines (OR: 5.35 , 2.13-12.4). Our data give strong support for the value of testing strict guidelines for limiting vascular catheter and antibiotic use, and limiting the invasive procedures.