Abstract

DE CICCO, Liliana et al. Implementación de un sistema de vigilancia activa de infecciones intrahospitalarias en una unidad de cuidados intensivos pediátrica. Arch. argent. pediatr. [online]. 2005, vol.103, n.2, pp.118-128. ISSN 0325-0075.

Introduction. The implementation of a surveillance system for nosocomial infections is a critical com­ponent of a program for infection control, specially in pediatric intensive care units (PICU), where the most susceptible patients are admitted. Objective. To describe the results of the implementa­tion of a surveillance system for nosocomial infec­tions in a PICU. Population, materials and methods. Since September 2000 all nosocomial infections were registered through a nosocomial infection surveillance system implemented in a PICU of a tertiary-care teaching hospital. According to the methodology established by the NNISS, the surveillance focused in device-associated infections. By using specific indicators, statistical process U control charts were constructed in order to determine the temporal outcome of those indicators and to allow early detection. The data were compared with NNISS reports. Results.Until November 2002, 112 nosocomial in­fections were detected among 1,682 patients (10.9 episodes per 1,000 patient-days). Although, ventilator-associated pneumonia (13.1 episodes per 1,000 ventilator-days) and catheter-associated urinary tract infections (7.1 episodes per 1,000 urinary catheter-days), were above the 75th percentile reported by the NNISS, the temporal outcome showed a decreasing tendency. The monthly expectant sur­veillance charts allowed detecting two outbreaks of central line-associated blood stream infections be­fore the end of the month, and to implement effec­tive control measures. Conclusions. The utilization of appropriate indica­tors, in addition to statistical control charts, allowed the comparison of our data with an external stan­dard and the effective identification of outbreaks, facilitating a quick implementation of infection con­trol measures.

Keywords : surveillance; nosocomial infections; pediatric intensive care unit.

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