Prevalence of nosocomial infections in Swiss children's hospitals

Infect Control Hosp Epidemiol. 2004 Sep;25(9):765-71. doi: 10.1086/502474.


Objective: To acquire data on pediatric nosocomial infections (NIs), which are associated with substantial morbidity and mortality and for which data are scarce.

Design: Prevalence survey and evaluation of a new comorbidity index.

Setting: Seven Swiss pediatric hospitals.

Patients: Those hospitalized for at least 24 hours in a medical, surgical, intensive care, or intermediate care ward.

Results: Thirty-five NIs were observed among 520 patients (6.7%; range per hospital, 1.4% to 11.8%). Bacteremia was most frequent (2.5 per 100 patients), followed by urinary tract infection (1.3 per 100 patients) and surgical-site infection (1.1 per 100 patients; 3.2 per 100 patients undergoing surgery). The median duration until the onset of infection was 19 days. Independent risk factors for NI were age between 1 and 12 months, a comorbidity score of 2 or greater, and a urinary catheter. Among surgical patients, an American Society of Anesthesiologists (ASA) score of 2 or greater was associated with any type of NI (P = .03). Enterobacteriaceae were the most frequent cause of NI, followed by coagulase-negative staphylococci; viruses were rarely the cause.

Conclusions: This national prevalence survey yielded valuable information about the rate and risk factors of pediatric NI. A new comorbidity score showed promising performance. ASA score may be a predictor of NI. The season in which a prevalence survey is conducted must be considered, as this determines whether seasonal viral infections are observed. Periodic prevalence surveys are a simple and cost-effective method for assessing NI and comparing rates among pediatric hospitals.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Age Distribution
  • Child
  • Child, Preschool
  • Comorbidity
  • Cross Infection / epidemiology*
  • Cross Infection / etiology
  • Cross Infection / prevention & control
  • Female
  • Hospitals, Pediatric / statistics & numerical data*
  • Humans
  • Infant
  • Infant, Newborn
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Population Surveillance
  • Prevalence
  • Switzerland / epidemiology