Evaluation of Nosocomial Infections in a Tertiary Pediatric Intensive Care Unit

Objective: Nosocomial infections are an important preventable cause of increased morbidity and mortality in critically ill children. Our study compared the clinical features, laboratory data, and prognostic variables of nosocomial infections (NI) in children in the tertiary pediatric intensive care unit (PICU). Methods: A retrospective evaluation of 48 pediatric patients aged 1 month to 18 years who had been admitted between February 2022 and January 2023 at University of Health Sciences Türkiye, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital was performed. Children with NI were included. Demographic clinical and outcome data were analyzed. Results: Twenty-seven patients (56.3%) were males. The median age was 32 months, and the length of stay in the PICU was 25 days (7-114). Respiratory diseases (50%) were the most common reasons for admission to the PICU, followed by sepsis (22.9%) and trauma (12.5%). The mortality rate was 18.8%. The requirement for renal replasman treatment was significantly higher in the non-survival group (p=0.017). Patients had similar prolonged PICU stay rates and requirements of mechanical ventilation, plasma exchange, and inotropic agents (p=0.472, p=0.320, p=0.432, p=0.068). Procalcitonin (PCT) (p=0.015), and procalcitonin/albumin ratio (PAR) (p=0.016) were also higher in the non-survival group than those in the survival group. Receiver operating characteristic (ROC) curves were used to predict mortality with PCT and PAR. According to ROC analysis, the cut-off values for PCT and PAR were found to be 1.705 (p=0.015), and 0.538 (p=0.016) respectively. Conclusion: Risk factors that cannot be changed, such as the underlying disease, should be considered in patients. Other modifiable risk factors for NIs will likely be the focus of efforts to enhance patient care.