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Surveillance of Healthcare Associated Infections in Pediatric Cancer Patients Between 2004 and 2009 in a Public Pediatric Hospital in Mexico City, Mexico

Hernández Orozco, Hilda MD; Lucas Resendiz, Esperanza RN; Luis Castañeda, Jose MD; De Colsa, Agustin MD; Ramirez Mayans, Jaime MD; Johnson, Kyle M. PhD; Gonzalez, Napoleon MD; Caniza, Miguela A. MD

Journal of Pediatric Hematology/Oncology: March 2014 - Volume 36 - Issue 2 - p 96–98
doi: 10.1097/MPH.0b013e31827e7f4c
Original Articles

Pediatric oncology and hematology patients are at increased risk of developing healthcare associated infections (HAIs). We conducted a prospective surveillance study on children with cancer admitted to the pediatric hematology and oncology units at a public pediatric hospital in Mexico from January 2004 to December 2009. The incidence of HAIs and groups at greatest risk for HAIs were analyzed. The annual HAI incidence rate and incidence density were calculated. Risk factors such as site of infection, HAI types, and cancer diagnosis were studied. A total of 9420 patients participated, and 409 had HAIs (479 episodes). Annual HAI rates were 3.7 to 5.5 per 100 admissions and the incidence density was 5.75 to 6 HAIs per 1000 inpatient days annually. There were 272 (56.8%) bloodstream infections, 45 (9.4%) pneumonia cases, and 44 (9.2%) skin and soft tissue infections. Children with acute lymphoblastic leukemia had 37.2% and those with acute myeloid leukemia had 16.4% of the HAIs. A total of 11.5% of the HAIs were in children with osteosarcoma. The most common pathogens were Gram-negative bacteria. The HAI-associated mortality rate was 3.7%. Although the overall HAI rate is in line with published reports, the mortality rate was higher, suggesting the incorporation of more aggressive methods to treat infections at our hospital.

*Department of Infectious Disease

Infection Prevention and Control Committee

Department of Gastroenterology, National Institute of Pediatrics, Mexico City, Mexico

§Department of Infectious Diseases

The International Outreach Program, St. Jude Children’s Research Hospital, Memphis, TN

Funded, in part, by National Pediatric Institute Mexican Ministry of Health and the American Lebanese Syrian Associated Charities.

The authors declare no conflict of interest.

Presented in part at St. Jude Children’s Research Hospital and the Pediatric Infectious Diseases Society Pediatric Microbial Research Conference 2011, Memphis, TN, February 11 to 12, 2011.

Reprints: Hilda Hernández Orozco, MD, Department of Infectious Disease, Instituto Nacional de Pediatria, Ave. Insurgentes Sur 3700, Cuicuilco, Mexico City, México 04530 (e-mail:

Received May 20, 2012

Accepted November 16, 2012

Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.