Nosocomial infection in the pediatric intensive care unit, Mashhad University of medical science Mashhad Iran

Background: Nosocomial infection is one of the important health problems of worldwide that can cause to death. These infections are common in pediatric hospital and neonatal intensive care unit. The most common infection related to urinary tract, pulmonary system and wound infection. Early antibiotics treatment in nosocomial infection has an important role that must be done properly and reasonably. So we decided to study nosocomial infection and early antibiotic therapy in these patients. We aimed to determine the most common infection related to the location and the most effective antibiotic at the beginning of treatment.Method: During one year, 2343 patients were hospitalized in Mashhad (Emam Reza hospital) that 811 (35.3%) of them were studied for nosocomial infections.Result: From 811 cases, 15 cases (1.87%) had nosocomial infection. The most frequent cause of hospitalization was the loss of consciousness due to CNS problems. The highest incidence of nosocomial infection in PICU of Emam Reza hospital was occurred following intubation and catheterization. Most patients with suspected nosocomial infection were treated with ceftriaxone while it is not effective and high percentage of ceftriaxone resistance has been reported. According to antibiograms obtained from patients with nosocomial infection, just the ceftazidime from the third generation of cephalosporin has been effective intermediately but we do not recommend it. In the cases suspected to nosocomial infection, it is better to use fourth generation of cephalosporin‟s (cefepime) with aminoglycosides (especially Amikacin), Tazobactam or Carbapenem (Imipenem, Meropenem).In some cases Vancomycin was effective.Conclusion: Nosocomial infection is inevitable, so the exact preventive methods can be somewhat controlled and the other way would be monitoring of antibiotic use, particularly in emergencies. In empirical therapy Cefipime, Vancomycin, Amikacin, Carbapeneme are recommended.