Device-associated infections in the pediatric intensive care unit at the American University of Beirut Medical Center

  • Ali Ismail American University of Beirut Medical Center, Beirut, Lebanon
  • Abdul-Karim El-Hage-Sleiman American University of Beirut, Beirut, Lebanon
  • Marianne Majdalani American University of Beirut Medical Center, Beirut, Lebanon
  • Rima Hanna-Wakim American University of Beirut Medical Center, Beirut, Lebanon
  • Souha Kanj American University of Beirut Medical Center, Beirut, Lebanon
  • Rana Sharara-Chami American University of Beirut Medical Center, Beirut, Lebanon
Keywords: device-associated infections, healthcare-associated infections, CLABSI, VAP, CAUTI, PICU

Abstract

Introduction: Device-associated healthcare-associated infections (DA-HAIs) are the principal threat to patient safety in intensive care units (ICUs).  The primary objective of this study was to identify the most common DA-HAIs in the pediatric intensive care unit (PICU) at the American University of Beirut Medical Center (AUBMC). Length of stay (LOS) and mortality, antimicrobial resistance patterns, and suitability of empiric antibiotic choices for DA-HAIs according to the local resistance patterns were also studied.

Methodology: This was a retrospective study that included all patients admitted to the PICU at AUBMC between January 2007 and December 2011. All patients admitted to the PICU having a placed central line, an endotracheal tube, and/or a Foley catheter were included. Data was extracted from the patients’ medical records through chart review. A total of 22 patients were identified with 25 central line-associated bloodstream infections (CLABSI), 25 ventilator-associated pneumonia (VAP), and 9 catheter-associated urinary tract infections (CAUTIs). The causing organisms, their resistance patterns, and the appropriateness of empiric antimicrobial therapy were reported.

Results: Gram-negative pathogens were found in 53% of the DA-HAIs, Gram-positive ones in 27%, and fungal organisms in 20%. A total of 80% of K. pneumonia isolates were extended-spectrum beta-lactamases (ESBL) producers, and 30% of Pseudomonas isolates were multidrug resistant. No methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE) were isolated. Based on culture results, the choice of empiric antimicrobial therapy was appropriate in 64% of the DA-HAIs.

Conclusions: After the care bundle approach is adopted in our PICU, DA-HAIs are expected to decrease further.

Author Biographies

Ali Ismail, American University of Beirut Medical Center, Beirut, Lebanon

Pediatric Intensive Care Unit, Department of Pediatrics and Adolescent Medicine

Abdul-Karim El-Hage-Sleiman, American University of Beirut, Beirut, Lebanon
Simulation Program, Faculty of Medicine
Marianne Majdalani, American University of Beirut Medical Center, Beirut, Lebanon
Pediatric Intensive Care Unit, Department of Pediatrics and Adolescent Medicine
Rima Hanna-Wakim, American University of Beirut Medical Center, Beirut, Lebanon
Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine
Souha Kanj, American University of Beirut Medical Center, Beirut, Lebanon
Division of Infectious Diseases, Department of Internal Medicine
Rana Sharara-Chami, American University of Beirut Medical Center, Beirut, Lebanon

Pediatric Intensive Care Unit, Department of Pediatrics and Adolescent Medicine

Simulation Program, Faculty of Medicine

Published
2016-06-30
How to Cite
1.
Ismail A, El-Hage-Sleiman A-K, Majdalani M, Hanna-Wakim R, Kanj S, Sharara-Chami R (2016) Device-associated infections in the pediatric intensive care unit at the American University of Beirut Medical Center. J Infect Dev Ctries 10:554-562. doi: 10.3855/jidc.7303
Section
Emerging Problems in Infectious Diseases