Ten-Year Consecutive Targeted Surveillance of Healthcare-Associated Infections in the Pediatric Intensive Care Unit of a Children's Hospital.

Abstract

Aims/background: Healthcare-associated infections (HAIs) represent a major public health challenge requiring urgent attention. These infections impose substantial burdens on both society and healthcare institutions. Patients in the pediatric intensive care unit (PICU) are at particularly high risk of HAI. This study aimed to analyze the status of targeted HAI surveillance in the PICU over 10 consecutive years and to provide evidence for improving HAI prevention and control strategies.

Methods: Data were collected from PICU patients of Children's Hospital of Chongqing Medical University who were monitored through a real-time HAI surveillance system from January 2015 to December 2024. Collected indicators included HAI incidence, infection sites, incidence of device-associated infections, distribution of pathogens, and the detection rates and incidence of multidrug-resistant organisms (MDROs).

Results: A total of 20,120 patients were monitored, with an overall HAI incidence of 3.36%. The annual incidence of HAI in the PICU exhibited a significant downward trend over the 10 years (p < 0.001). The respiratory system was the most common site of infection. The incidences of central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infection (CAUTI) were 0.70 per 1000 central line-days, 1.84 per 1000 mechanical ventilation-days, and 0.11 per 1000 urinary catheter-days, respectively. A total of 643 pathogenic strains were isolated, predominantly Gram-negative bacteria (73.41%), with Acinetobacter baumannii being the most frequently detected (18.35%). The detection rates of carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-resistant Klebsiella pneumoniae (CRKP) were 67.33% and 31.42%, respectively, both showing significant upward trends over the decade (both p < 0.001). The detection rate of carbapenem-resistant Escherichia coli (CREC) was 16.30% and showed a significant downward trend for 10 consecutive years (p < 0.001). The incidence of MDRO-related HAI was 0.68%, with CRAB (0.32%) and CRKP (0.13%) having the two highest incidence rates.

Conclusion: The incidence of HAI in the PICU significantly decreased over the study period, indicating progress in infection prevention and control. However, CLABSI, VAP, and MDROs remain key priorities in ongoing HAI prevention efforts in the PICU.