Nosocomial infections in immunocompromised children.

Immunocompromised children are at high risk for developing nosocomial infec tions which may cause significant morbidity and mortality in this populatio n. In paediatric oncology, reported prevalence of nosocomial infections var ies from 10 to 20 %. Major predisposing factors are neutropenia, central ve nous catheter, corticosteroid therapy and hospital construction or renovati on for invasive aspergillosis. The management of patients with febrile neut ropenia should take into account the previous history of infection and the microbiologic environment of each department. Nowadays, Gram positives infe ctions are predominant, but fungal infections remain a major threat. In org an transplant recipients, wound infections are the main early problems, fol lowed by viral infections often due to the donor CMV seropositivity. In HIV -infected children, nosocomial infections are difficult to define, and can implicate unusual pathogens. In general, adapted preventive infection contr ol strategy warrants prospective studies. (C) Editions scientifiques et med icales Elsevier SAS.