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Update on infection control challenges in special pediatric populations

Balkhy, Hanan H.a; Zingg, Walterb

Current Opinion in Infectious Diseases: August 2014 - Volume 27 - Issue 4 - p 370–378
doi: 10.1097/QCO.0000000000000084
NOSOCOMIAL AND HEALTHCARE RELATED INFECTIONS: Edited by Trish M. Perl

Purpose of review: Compared with adults, neonatal and pediatric populations are especially vulnerable patients who have specific diagnostic and therapeutic differences; therefore, the standard infection control practices designed for adults are sometimes not effective or need modifications to work. This review focuses on the recent literature addressing the challenges and successes in preventing healthcare-associated infections (HAIs) in children.

Recent findings: Improving the implementation of pediatric versions of preventive bundles focusing on proper catheter insertion and maintenance, mainly as a part of a larger multimodal strategy, is effective in reducing the central-line-associated bloodstream infections in neonatal and pediatric populations including oncology patients. Appropriate feeding, antimicrobial stewardship, and infection control measures should be combined in reducing necrotizing enterocolitis in preterm neonates. Implementing a multimodal bundle strategy adapted for pediatric population is successful in preventing ventilator-associated pneumonia. Appropriate use of antimicrobial prophylaxis remains the cornerstone for preventing surgical-site infections irrespective of age, with few additional effective adjuvant preventive practices in specific pediatric patients.

Summary: Several evidence-based practices are effective in reducing the incidence and the impact of HAIs in children; however, proper implementation remains a challenge. Additionally, several adult preventive practices are still unestablished in children and need further thorough examination.

aDepartment of Infection Prevention and Control, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, WHO Collaborating Centre for Infection Control, Riyadh, Kingdom of Saudi Arabia

bInfection Control Program, Faculty of Medicine, WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Geneva, Switzerland

Correspondence to Hanan H. Balkhy, MD, MMed, FAAP, Department of Infection Prevention and Control, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, WHO Collaborating Centre for Infection Control, P.O. Box 22490, Riyadh 11426, Kingdom of Saudi Arabia. Tel: +996 118043720; fax: +966 112520437; e-mail: balkhyh@ngha.med.sa (preferred); balkhyh@hotmail.com

© 2014 Lippincott Williams & Wilkins, Inc.