Hospital-associated infections in children: a prospective post-discharge follow-up survey in three different paediatric hospitals

Summary Background Reported viral hospital-associated infection (HAI) frequencies have ranged from 1% to 24% between paediatric wards and hospitals. Reasons for this variation remain unclear. Aim To evaluate the rate of viral HAIs and risk factors in three different paediatric hospitals. Methods Data were collected prospectively for two years in one infectious disease ward and three general paediatric wards in Finland and Switzerland. Infections were recorded during the hospitalization and one week after discharge. Ward-specific risk factors for HAIs within each ward were searched by using multivariate logistic regression analysis. Findings Altogether 5119 patients were hospitalized. Total HAI frequency was 12.2%, with 2.4% of the patients developing HAI in hospital, most often gastroenteritis, and 9.8% [95% confidence interval (CI): 8.9–10.8%] within 72 h of discharge. HAI rates varied from 5.8% to 17.1% between the wards, the highest rate being in a general paediatric ward where shared rooms were common and active cohorting according to viral aetiology was not done. Shared room (OR: 5.45; 95% CI: 2.44–12.2 in a general ward treating infants), longer hospitalization (OR: 1.42 per day; 95% CI: 1.20–1.67 in an infectious disease ward) and young age (OR: 0.71 per year; 95% CI: 0.51–0.98 in general paediatric ward for children aged >1 year) increased risk of HAI in hospital. Conclusion Most viral HAIs in paediatric wards become evident after discharge. Single room bedding appears to be effective in preventing HAIs, especially the spread of respiratory viruses. It also appears that caring for patients with contagious diseases in a separate unit is advantageous.