Hospital infection care differs for children, adults

The differences between adult and pediatric patients often are overlooked in treatment and prevention efforts related to healthcare-associated infections (HAIs), say two Cleveland Clinic Children's Hospital physicians in the latest issue of the Journal of the American Medical Association (JAMA).

Rates of central line associated bloodstream infections (CLABSI), surgical site infections (SSIs), and respiratory viral infections differ between children and adults--reflecting the "unique susceptibilities" of each population, study authors reported at a Washington, D.C., JAMA briefing on Tuesday that highlighted infections.

Current efforts to reduce the rates of HAI in children are hampered many times by the lack of pediatric-specific research, a lack of national pediatric-specific quality measures to guide prevention of SSIs, and the implementation of infection prevention practices that have been validated only in adult populations.

The authors noted the variation in HAIs among the two groups: Overall, pediatric patients have higher rates of bloodstream infections and viral lower respiratory tract infections than adult patients. However, rates of catheter-related urinary tract infections, ventilator-associated pneumonia, and SSIs are higher among adult patients--although rates for particular pediatric surgical procedures may be high.

Reported rates, for instance, for CLABSI frequently are higher in pediatric ICUs than in adult ICUs. Unique considerations are needed in the prevention of CLABSI in pediatric patients since catheters need to be maintained for longer periods of time because of difficult vascular access and the need to obtain blood.

Overall, the authors say, HAIs in children need to be studied in a systematic manner, with collaborating efforts needed for implementation of best practices and the resources devoted to the task by funding agencies.

For more information:
- see the JAMA extract
- read Becker's ASC Review article

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