Nosocomial infections in pediatric cancer patients

Abstract

Objective: Pediatric cancer patients comprise an important risk group of nosocomial infections (NI) due to long hospital stay, underlying diseases and intensive chemotherapies. The aim of this study was to evaluate NI in the pediatric hemato-oncology clinic over a one year period.Material and Methods: Nosocomial infections in the pediatric hemato-oncology clinic (with 19 beds) were evaluated over a one-year period. Nosocomial infection was defined according to the criteria of the Centers for Disease Control and Prevention (CDC).Results: Nosocomial infections were defined according to the CDC criteria. Of 342 admitted pediatric cancer patients, 44 (12.8%) developed NI. Sixty-eight NI occurred in 44 patients (1.54 NI per patient). The NI rate was found to be 19.8 per 100 discharge, and 15.6 per 1000 patient-days. Gram positive agents comprised 45.6%, Gram negative agents 43.4% and fungi 11% of all culture-positive NI. Of 44 children with NI, 57% (n=25) had acute lymphoblastic leukemia (ALL), 18% (n=8) had non-Hodgkins lymphoma, 9% (n=4) had acute myeloblastic leukemia (AML), 7% (n=3) had neuroblastoma, and 9% (n=4) had other solid tumors. NI was found at a rate of 14.8/ 1000 patient-days, specifically in children with ALL. The average hospital stay of children with NI was 73.6 +/- 53.4 days (median 53). NI was diagnosed on average after 33.9 +/- 28.3 days of hospitalization. Ten of 44 children with HI (22.7%) died. Seventy percent of these patients were in the terminal stage of their illness. The overall mortality rate was 14.7% in 68 cases of NI.Conclusion: Our results reveal that our center has comparable NI and mortality rates and a similar etiologic agent distribution with regard to other developed countries.