Risk factors nosocomial respiratory infections

Table 1 Additional Factors that Place Infants and Children at Risk for Nosocomial Respiratory Infections...

Nosocomial lower respiratory tract infections (LRI) represent a significant concern to those caring for hospitalized infants and children because of both their frequency and their potential severity. Pneumonia is the second most common nosocomial infections in all patients hospitalized in the United States regardless of age (1,2). Data from the National Nosocomial Infections Surveillance (NNIS) System documents that nosocomial pneumonia is the second most frequent hospital-acquired infection in critically ill infants and children as well (2,3). Many of the significant risk factors for the development of nosocomial pneumonia previously identified in adult patients, such as severe underlying cardiopulmonary disease, immunosuppression, depressed sensorium, and prior thoracoabdominal surgery, are present in pediatric patients and place them similarly at risk for nosocomial lower respiratory tract infections. In addition, there are specific clinical situations that are unique for neonatal and pediatric patients that provide additional risks for severe nosocomial lower respiratory tract infections (Table 1). 

Although less information is available concerning the actual frequency and risk factors for nosocomial lower respiratory tract infection in children as compared to adults, there is adequate documentation of its importance, particularly for patients hospitalized within intensive care settings (3-7). Nosoco-... 

Colinearity between factors prevented some obvious risk factors such as mechanically assisted ventilation and intubation from reaching statistical significance. The close association between many risk factors would likely impact any evaluation of risk for development of nosocomial lower respiratory tract infections in children because multiple simultaneous interventions and therapies would be similar in critically ill children. Also, the small number of patients in this study did not allow for identification of specific underlying diagnosis as risk factors (e.g. severe burns, polytrauma). 

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