Epidemiology of healthcare-associated bloodstream infections in the paediatric intensive care unit

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dc.contributor.advisorAppel, Ilseen_ZA
dc.contributor.advisorDramowski, Angelaen_ZA
dc.contributor.authorRamsunder, Prishanien_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health.en_ZA
dc.date.accessioned2021-05-28T09:06:53Zen_ZA
dc.date.accessioned2022-02-22T10:15:27Zen_ZA
dc.date.available2022-02-23T03:00:10Zen_ZA
dc.date.issued2021-12en_ZA
dc.descriptionThesis (MMed)--Stellenbosch University, 2021.en_ZA
dc.description.abstractENGLISH ABSTRACT: Abstract Background: Limited data is available from African country paediatric intensive care units (PICU) on the burden, pathogen profile and outcome of healthcare-associated bloodstream infections (HA-BSI). Methods: A retrospective record review was conducted in the PICU at Tygerberg Hospital, South Africa between January 2015 and December 2017. Data on infection rate, pathogen profile, patient demographics and outcome were collected for all children diagnosed with HA-BSI (a laboratory-confirmed BSI arising > 48 hours after admission to the PICU). Results: Over the 3-year study period 2643 patients were admitted to PICU and 1116 blood cultures were collected. The blood culture pathogen yield was 7.5% (84/1116) comprising 27 community-acquired BSI (32.1%), 11 HA-BSI acquired prior to PICU admission (13.1%) and 46 HA-BSI acquired in PICU (54.8%). The incidence rate of HA-BSI acquired in the PICU was 4.7/1000 patient days. No source of infection was identified for 62.5% of HA-BSI cases. The majority of patients affected by HA-BSI were infants (24/46; 52.2%), malnourished (50%) and HIV-uninfected (91.3%). The clinical impact of HA-BSI was severe, with 41% developing a new requirement for mechanical ventilation. K. pneumoniae, A. baumannii and Candida species were the most prevalent HA-BSI pathogens and exhibited substantial antimicrobial resistance. Patient outcomes were poor with a crude mortality rate of 41.3% and a median length of PICU stay of 15 days. Conclusion: Rates of HA-BSI were comparable to that reported from high-income country PICU’s, but most HA-BSI pathogens exhibited substantial antimicrobial resistance, similar to that reported from other LMIC PICUs.en_ZA
dc.description.abstract"Geen opsomming biskikbaar."af_ZA
dc.description.versionMastersen_ZA
dc.embargo.terms2021-12-01en_ZA
dc.format.extent23 pages : illustrationsen_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/124192en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch Universityen_ZA
dc.rights.holderStellenbosch Universityen_ZA
dc.subjectPediatric intensive careen_ZA
dc.subjectBloodstream infectionsen_ZA
dc.subjectBlood cultureen_ZA
dc.subjectPathogenic microorganismsen_ZA
dc.subjectHIV (Viruses) -- Epidemiologyen_ZA
dc.subjectUCTDen_ZA
dc.titleEpidemiology of healthcare-associated bloodstream infections in the paediatric intensive care uniten_ZA
dc.typeThesisen_ZA
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