Skip to main content
NCBI home page
The Yale Journal of Biology and Medicine logoLink to The Yale Journal of Biology and Medicine
. 1984 Mar-Apr;57(2):185–197.

Nosocomial infections in the pediatric intensive care unit.

R S Baltimore
PMCID: PMC2589799  PMID: 6382835

Abstract

Nosocomial (hospital-acquired) infections are a major complication of serious illnesses. Severely ill patients have a greater risk of acquiring nosocomial infections, so this problem is greatest in intensive care units. Studies have demonstrated that nosocomial infections are largely preventable. Adherence to recommended techniques for patient care will have the greatest benefit in the intensive care unit. In this paper the background epidemiology of nosocomial infections is reviewed and related to pediatrics and intensive care units. Types of diseases, assistance equipment, and monitoring devices which are associated with a high risk of nosocomial infections are emphasized and specific steps for lowering this risk are listed.

Full text

PDF
185

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albert R. K., Condie F. Hand-washing patterns in medical intensive-care units. N Engl J Med. 1981 Jun 11;304(24):1465–1466. doi: 10.1056/NEJM198106113042404. [DOI] [PubMed] [Google Scholar]
  2. Donowitz L. G., Marsik F. J., Hoyt J. W., Wenzel R. P. Serratia marcescens bacteremia from contaminated pressure transducers. JAMA. 1979 Oct 19;242(16):1749–1751. [PubMed] [Google Scholar]
  3. Duma R. J., Warner J. F., Dalton H. P. Septicemia from intravenous infusions. N Engl J Med. 1971 Feb 4;284(5):257–260. doi: 10.1056/NEJM197102042840508. [DOI] [PubMed] [Google Scholar]
  4. Felts S. K., Schaffner W., Melly M. A., Koenig M. G. Sepsis caused by contaminated intravenous fluids. Epidemiologic, clinical, and laboratory investigation of an outbreak in one hospital. Ann Intern Med. 1972 Dec;77(6):881–890. doi: 10.7326/0003-4819-77-6-881. [DOI] [PubMed] [Google Scholar]
  5. Fisher M. C., Long S. S., Roberts E. M., Dunn J. M., Balsara R. K. Pseudomonas maltophilia bacteremia in children undergoing open heart surgery. JAMA. 1981 Oct 2;246(14):1571–1574. [PubMed] [Google Scholar]
  6. Freeman J., McGowan J. E., Jr Risk factors for nosocomial infection. J Infect Dis. 1978 Dec;138(6):811–819. doi: 10.1093/infdis/138.6.811. [DOI] [PubMed] [Google Scholar]
  7. Gardner P., Carles D. G. Infections acquired in a pediatric hospital. J Pediatr. 1972 Dec;81(6):1205–1210. doi: 10.1016/s0022-3476(72)80264-6. [DOI] [PubMed] [Google Scholar]
  8. Gardner R. M., Schwartz R., Wong H. C., Burke J. P. Percutaneous indwelling radial-artery catheters for monitoring cardiovascular function. Prospective study of the risk of thrombosis and infection. N Engl J Med. 1974 May 30;290(22):1227–1231. doi: 10.1056/NEJM197405302902205. [DOI] [PubMed] [Google Scholar]
  9. Garibaldi R. A., Burke J. P., Dickman M. L., Smith C. B. Factors predisposing to bacteriuria during indwelling urethral catheterization. N Engl J Med. 1974 Aug 1;291(5):215–219. doi: 10.1056/NEJM197408012910501. [DOI] [PubMed] [Google Scholar]
  10. Garner J. S., Simmons B. P. Guideline for isolation precautions in hospitals. Infect Control. 1983 Jul-Aug;4(4 Suppl):245–325. [PubMed] [Google Scholar]
  11. Goldmann D. A., Durbin W. A., Jr, Freeman J. Nosocomial infections in a neonatal intensive care unit. J Infect Dis. 1981 Nov;144(5):449–459. doi: 10.1093/infdis/144.5.449. [DOI] [PubMed] [Google Scholar]
  12. Greene J. F., Jr, Fitzwater J. E., Clemmer T. P. Septic endocarditis and indwelling pulmonary artery catheters. JAMA. 1975 Aug 25;233(8):891–892. [PubMed] [Google Scholar]
  13. Grieble H. G., Colton F. R., Bird T. J., Toigo A., Griffith L. G. Fine-particle humidifiers. Source of Pseudomonas aeruginosa infections in a respiratory-disease unit. N Engl J Med. 1970 Mar 5;282(10):531–535. doi: 10.1056/NEJM197003052821003. [DOI] [PubMed] [Google Scholar]
  14. Hall C. B., Douglas R. G., Jr, Geiman J. M., Messner M. K. Nosocomial respiratory syncytial virus infections. N Engl J Med. 1975 Dec 25;293(26):1343–1346. doi: 10.1056/NEJM197512252932604. [DOI] [PubMed] [Google Scholar]
  15. Hall C. B., Douglas R. G., Jr Modes of transmission of respiratory syncytial virus. J Pediatr. 1981 Jul;99(1):100–103. doi: 10.1016/s0022-3476(81)80969-9. [DOI] [PubMed] [Google Scholar]
  16. Hall C. B., Kopelman A. E., Douglas R. G., Jr, Geiman J. M., Meagher M. P. Neonatal respiratory syncytial virus infection. N Engl J Med. 1979 Feb 22;300(8):393–396. doi: 10.1056/NEJM197902223000803. [DOI] [PubMed] [Google Scholar]
  17. Hemming V. G., Overall J. C., Jr, Britt M. R. Nosocomial infections in a newborn intensive-care unit. Results of forty-one months of surveillance. N Engl J Med. 1976 Jun 10;294(24):1310–1316. doi: 10.1056/NEJM197606102942403. [DOI] [PubMed] [Google Scholar]
  18. Johanson W. G., Pierce A. K., Sanford J. P. Changing pharyngeal bacterial flora of hospitalized patients. Emergence of gram-negative bacilli. N Engl J Med. 1969 Nov 20;281(21):1137–1140. doi: 10.1056/NEJM196911202812101. [DOI] [PubMed] [Google Scholar]
  19. Leclair J. M., Zaia J. A., Levin M. J., Congdon R. G., Goldmann D. A. Airborne transmission of chickenpox in a hospital. N Engl J Med. 1980 Feb 21;302(8):450–453. doi: 10.1056/NEJM198002213020807. [DOI] [PubMed] [Google Scholar]
  20. Maki D. G., Goldman D. A., Rhame F. S. Infection control in intravenous therapy. Ann Intern Med. 1973 Dec;79(6):867–887. doi: 10.7326/0003-4819-79-6-867. [DOI] [PubMed] [Google Scholar]
  21. Northey D., Adess M. L., Hartsuck J. M., Rhoades E. R. Microbial surveillance in a surgical intensive care unit. Surg Gynecol Obstet. 1974 Sep;139(3):321–325. [PubMed] [Google Scholar]
  22. Pace N. L., Horton W. Indwelling pulmonary artery catheters. Their relationship to aspetic thrombotic endocardial vegetations. JAMA. 1975 Aug 25;233(8):893–894. doi: 10.1001/jama.233.8.893. [DOI] [PubMed] [Google Scholar]
  23. Pierce A. K., Sanford J. P., Thomas G. D., Leonard J. S. Long-term evaluation of decontamination of inhalation-therapy equipment and the occurrence of necrotizing pneumonia. N Engl J Med. 1970 Mar 5;282(10):528–531. doi: 10.1056/NEJM197003052821002. [DOI] [PubMed] [Google Scholar]
  24. Pollack M., Charache P., Nieman R. E., Jett M. P., Reimhardt J. A., Hardy P. H., Jr Factors influencing colonisation and antibiotic-resistance patterns of gram-negative bacteria in hospital patients. Lancet. 1972 Sep 30;2(7779):668–671. doi: 10.1016/s0140-6736(72)92084-3. [DOI] [PubMed] [Google Scholar]
  25. Selden R., Lee S., Wang W. L., Bennett J. V., Eickhoff T. C. Nosocomial klebsiella infections: intestinal colonization as a reservoir. Ann Intern Med. 1971 May;74(5):657–664. doi: 10.7326/0003-4819-74-5-657. [DOI] [PubMed] [Google Scholar]
  26. Spratt H. C., Marks M. I., Gomersall M., Gill P., Pai C. H. Nosocomial infantile gastroenteritis associated with minirotavirus and calicivirus. J Pediatr. 1978 Dec;93(6):922–926. doi: 10.1016/S0022-3476(78)81212-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Stamm W. E., Colella J. J., Anderson R. L., Dixon R. E. Indwelling arterial catheters as a source of nosocomial bacteremia. An outbreak caused by Flavobacterium Species. N Engl J Med. 1975 May 22;292(21):1099–1102. doi: 10.1056/NEJM197505222922105. [DOI] [PubMed] [Google Scholar]
  28. Stamm W. E. Guidelines for prevention of catheter-associated urinary tract infections. Ann Intern Med. 1975 Mar;82(3):386–390. doi: 10.7326/0003-4819-82-3-386. [DOI] [PubMed] [Google Scholar]
  29. Stamm W. E. Nosocomial infections: etiologic changes, therapeutic challenges. Hosp Pract (Off Ed) 1981 Aug;16(8):75–88. doi: 10.1080/21548331.1981.11946817. [DOI] [PubMed] [Google Scholar]
  30. Steere A. C., Mallison G. F. Handwashing practices for the prevention of nosocomial infections. Ann Intern Med. 1975 Nov;83(5):683–690. doi: 10.7326/0003-4819-83-5-683. [DOI] [PubMed] [Google Scholar]
  31. Stein J. M., Pruitt B. A., Jr Suppurative thrombophlebitis. A lethal iatrogenic disease. N Engl J Med. 1970 Jun 25;282(26):1452–1455. doi: 10.1056/NEJM197006252822603. [DOI] [PubMed] [Google Scholar]
  32. Warren J. W., Platt R., Thomas R. J., Rosner B., Kass E. H. Antibiotic irrigation and catheter-associated urinary-tract infections. N Engl J Med. 1978 Sep 14;299(11):570–573. doi: 10.1056/NEJM197809142991103. [DOI] [PubMed] [Google Scholar]
  33. Welliver R. C., McLaughlin S. Unique epidemiology of nosocomial infection in a children's hospital. Am J Dis Child. 1984 Feb;138(2):131–135. doi: 10.1001/archpedi.1984.02140400017004. [DOI] [PubMed] [Google Scholar]

Articles from The Yale Journal of Biology and Medicine are provided here courtesy of Yale Journal of Biology and Medicine

RESOURCES