Infections in Critically Ill Children

Health care-associated infections (HAI) directly influence the survival of children in pediatric intensive care units (PICU), the most common being central line-associated bloodstream infection (CLABSI) 25-30%, followed by ventilator-associated pneumonia (VAP) 20-25%, and others such as catheter-associated urinary tract infection (CAUTI) 15%, surgical site infection (SSI) 11%. HAIs complicate the course of the disease, especially the critical one, thereby increasing the mortality, morbidity, length of hospital stay, and cost. The incidence of HAI in Western countries is 6.1-15.1% and in India, it is 10.5 to 19.5%. The advances in healthcare practices have reduced the incidence of HAIs in the recent years which is possible due to strict asepsis, hand hygiene practices, surveillance of infections, antibiotic stewardship, and adherence to bundled care. The burden of drug resistance and emerging infections are increasing with limited antibiotics in hand, is still a dreadful threat. The most common manifestation of HAIs is fever in PICU, hence the appropriate targeted search to identify the cause of fever should be done. Proper isolation practices, judicious handling of devices, regular microbiologic audit, local spectrum of organisms, identification of barriers in compliance of hand hygiene practices, appropriate education and training, all put together in an efficient and sustained system improves patient outcome.

Automated summary

Healthcare-associated infections (HAI) have a direct impact on the survival of children in pediatric intensive care units (PICU), with central line-associated bloodstream infection (CLABSI) being the most common at 25-30%, followed by ventilator-associated pneumonia (VAP) at 20-25%, and other infections like catheter-associated urinary tract infection (CAUTI) at 15% and surgical site infection (SSI) at 11%. HAIs complicate the disease course, especially in critical cases, leading to increased mortality, morbidity, hospital stays, and costs. Recent advances in healthcare practices, including asepsis, hand hygiene, infection surveillance, antibiotic stewardship, and bundled care, have reduced the incidence of HAIs. However, the rise of drug-resistant infections remains a significant threat.