Nosocomial infections in pediatrics. Problems and future.

High incidence of nosocomial infections in children is largely explained by immunodeficiency, particularly in newborns. Central venous catheter is the main risk factor and coagulase negative staphylococcus the main pathogen i n cause. Large variations of nosocomial infection incidences are observed b y Nososcomial Infection Surveillance Networks and depend on the pediatric s peciality. The highest rate is observed in neonatal intensive care, where i ncidence density of catheter-related sepsis varies from four to 23 infectio ns for 1000 catheter-days. Local surveillance in each ward, risk factors an d knowledge of bacterial epidemiology allow the development of rational pre ventive and therapeutic protocols. However, prophylactic use of vancomycin is dangerous and immunoglobulins are inefficient. (C) 2000 Editions scienti fiques et medicales Elsevier SAS.