Bloodstream Infection in Children Managed at a Tertiary Hospital in Oman

Abstract

Objectives: Little is known about bloodstream infection (BSI) among children in Oman. This study was done to assess the local epidemiology and outcome of BSI among Omani children. Methods: A retrospective study of laboratory-confirmed BSI was conducted among children (0 -12 years) managed at Sultan Qaboos University Hospital, Oman, over a 5-year period (2014-2018). Patients’ demographic, clinical, and laboratory data were extracted from the hospital’s electronic records and were used to assess BSI rates and outcome. Results: A total of 1253 positive blood cultures were identified of which 592 (47.2%) were regarded as contaminants. Overall, 404 (32.2%) significant episodes of BSI were identified in 272 patients of whom 346 (85.6%) were ≤ 5 years of age and 366 (90.6%) had comorbidities. The 5-years incidence of BSI was 13 per 1000 admissions. Three hundred and thirty-three (82.4%) episodes were healthcare-related infections. Enterobacterales (152; 37.6%) were the most common organisms identified followed by coagulase-negative staphylococci (63; 15.5%). About 40% of Gram-negative organisms were resistant to 3rd generation cephalosporins. The crude mortality rate at 30 days was 9.2%. Pediatric Intensive Care Units admission (COR = 2.24, 95% CI: 0.98-4.78) and the presence of Graft-Versus-Host Disease (COR = 7.99, 95% CI: 1.52-37.76) were associated with increased death within 30 days. The multivariate logistic regression analysis showed that Pseudomonas aeruginosa (AOR = 18.46, 95% CI: 3.96-97.84) was the only independent predictor of increasing 30-day mortality in this cohort. Conclusions: This study found a high rate of hospital-related BSI in children in Oman. This highlights the need to optimize infection control strategies and the care of central vein access devices.