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Abstract O-20: 5 YEARS AND 50 000 PIC DAYS - HOW BIG A PROBLEM ARE HEALTH CARE ASSOCIATED INFECTIONS (HCAI) IN CRITICALLY ILL CHILDREN?

Cassidy, J.1; Campbell, G.2; Martin, J.2; Milner, P.3; Gray, J.3

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 10–11
doi: 10.1097/01.pcc.0000537362.41646.0c
Oral Abstracts
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1Birmingham Children’s Hospital, PICU, Birmingham, United Kingdom

2Birmingham Children’s Hospital, Paediatric Intensive Care Unit, Birmingham, United Kingdom

3Birmingham Children’s Hospital, Microbiology, Birmingham, United Kingdom

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Aims & Objectives:

To establish trends in HCAI in children admitted to PICU with time and the impact of an ongoing surveillance and analysis programme.

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Methods

Review of all HCAI cases in children admitted to PICU between January 2013-December 2017 and the impact of ongoing quality improvement measures.

HCAI considered included central line associated blood stream infections (CLABSI), ventilator associated pneumonia (VAP), surgical site infections (SSI), hospital acquired blood stream infections (HA BSI), catheter associated urinary tract infections (CA UTI) and mucosal barrier injury blood stream infections (MBI BSI).

Cases were notified clinically and by analysis of microbiology data and validated at a monthly multidisciplinary HCAI meeting with thematic analysis.

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Results

There were 7062 admissions over the 5 years with 56 623 patient days analysed. Overall PIC mortality was 5.5%

There were 184 confirmed HCAI in 165 children (2.4%). 16 children had >/=2 during their PIC stay. 86/184 (47%) were considered preventable.

35 (21%) died but in only one was the HCAI the cause of death.

CA UTI’s were most common, followed by CLABSI’s. There were significant changes with time and QI interventions. The rate of CLABSI’s fell from 1/1000 CVC days in 2013 to 0.25 in 2017. Significant reductions in VAP and SSI were also achieved but conversely CA UTI rates rose.

Overall HCAI rates fell from 3.5/1000 patient days to 2.3.

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Conclusions

HCAI rates are lower than previously published in this 5 year study but up to half may be prevented with significant impacts on antibiotic exposure and morbidity.

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©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies