Risk factors and cost of nosocomial infections in pediatric patients with traumatic brain injury.

Abstract

Objective: This study aimed to determine the factors that increase nosocomial infections (NIs) in pediatric patients with traumatic brain injury (TBI) and the effects on both treatment cost and length of hospital stay.

Methods: We performed a case-control study on patients admitted to the pediatric intensive care unit (PICU) with (n=66) or without (n=120) TBI between 2012 and 2014. The risk factors, length of stay, and costs of NIs were determined.

Results: Data for 186 patients were analyzed. One hundred and twenty patients were controls (54 males vs. 66 females), while 66 were cases (27 males vs. 39 females). Seventeen out of the 186 PICU patients had NIs. About 7.6% of TBI patients had infections whereas 10% of control groups had NIs (p=0.58). The most isolated microbial agent was Acinetobacterbaumannii (four cases). Thirteen (76.5%) out of the 17 infections were catheter-related bloodstream infections. The mean expenses per PICU patient were $762, with an additional cost of $2081 for patients with nosocomial contamination.

Conclusion: The use of catheters was the most critical risk factor for NIs in our study probably underestimated the cost for several reasons. Nevertheless, the findings supported our hypothesis about the additional burden of nosocomial spread on PICU patients. This study's results should help provide evidence on cost-effectiveness or calculate the cost-benefit ratio of reducing NIs in children.