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Objective: To determine the prevalence of intensive care unit-acquired infections, a major cause of morbidity in pediatric intensive care unit (PICU) patients., Methods: Pediatric Prevention Network hospitals (n = 31) participated in a point-prevalence survey on August 4, 1999. Data collected for all PICU inpatients included demographics, infections, therapeutic interventions, and outcomes., Results: There were 512 patients in 35 PICUs. The median age was 2.2 years (range, <1 day-35.4 years). Seventy-five PICU-acquired infections occurred among 61 (11.9%) patients. The most frequently reported sites were bloodstream (31 [41.3%]), lower respiratory tract (17 [22.7%]), urinary tract (10 [13.3%]), or skin/soft tissue (6 [8.0%]). The most frequent pathogens were coagulase-negative staphylococci (in 16 [21.3%] infections), Candida spp. (13 [17.3%]), enterococci (10 [13.3%]), Staphylococcus aureus (9 [12.0%]), or Pseudomonas aeruginosa (8 [10.7%]). Age-adjusted risk factors for infection included central intravenous catheters (relative risk [RR], 4.1; 95% confidence intervals [CI], 2.4-7.1), arterial catheters (RR, 2.4; 95% CI, 1.5-3.9), total parenteral nutrition (RR, 5.5; 95% CI, 3.6-8.5), or mechanical ventilation (RR, 3.9; 95% CI, 2.2-6.8). Infection was associated with higher age-adjusted risk of death within 4 weeks of the survey (RR, 3.4; 95% CI, 1.7-6.5)., Conclusions: This national multicenter study documented the high prevalence of PICU-acquired infections. Preventing these infections should be a national priority.

Objectives: Patients admitted to neonatal intensive care units (NICUs) are at high risk of nosocomial infection. We conducted a national multicenter assessment of nosocomial infections in NICUs to determine the prevalence of infections, describe associated risk factors, and help focus prevention efforts., Study Design: We conducted a point prevalence survey of nosocomial infections in 29 Pediatric Prevention Network NICUs. Patients present on the survey date were included. Data were collected on underlying diagnoses, therapeutic interventions/treatments, infections, and outcomes., Results: Of the 827 patients surveyed, 94 (11.4%) had 116 NICU-acquired infections: bloodstream (52.6%), lower respiratory tract (12.9%), ear-nose-throat (8.6%), or urinary tract infections (8.6%). Infants with infections were of significantly lower birth weight (median 1006 g [range 441 to 4460 g] vs 1589 g [range 326 to 5480 g]; P <.001) and had longer median durations of stay than those without infections (88 days [range 8 to 279 days] vs 32 days [range 1 to 483 days]; P <.001). Most common pathogens were coagulase-negative staphylococci and enterococci. Patients with central intravascular catheters (relative risk = 3.81, CI 2.32-6.25; P <.001) or receiving total parenteral nutrition (relative risk = 5.72, CI 3.45-9.49; P <.001) were at greater risk of bloodstream infection., Conclusions: This study documents the high prevalence of nosocomial infections in patients in NICUs and the urgent need for more effective prevention interventions.

As infection control evolved into an art and science through the years, many infection control practices have become infection control dogmas (principles, beliefs, ideas, or opinions). In this "Reality Check" session of the 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections, we assessed participants' perceptions of prevalent infection control dogmas. The majority of participants agreed with all dogmas having evidence of efficacy, except for the dogma on the frequency of changing mechanical-ventilator tubing. In contrast, the majority of participants disagreed with dogmas not having evidence of efficacy, except for the dogma on perineal care, umbilical cord care, and reminder signs for isolation precaution. As for controversial dogmas, many of the responses were almost evenly distributed between "agree" and "disagree." Infection control professionals were knowledgeable about evidence-based infection control practices. However, many of the respondents still believe in some of the non-evidence-based dogmas.

Antimicrobial resistance, including vancomycin resistance in enterococci (VRE), is a growing problem in healthcare facilities. This "Reality Check" session focused on the question of whether we should try to detect and isolate patients colonized or infected with VRE.