A nine-year surveillance of healthcare-associated infections in a pediatric Intensive Care Unit: epidemiology, pathogens, and antimicrobial resistance trends

Authors

DOI:

https://doi.org/10.3855/jidc.22442

Keywords:

pediatric intensive care unit, healthcare-associated infections, antimicrobial resistance, Gram-negative bacteria, bloodstream infections, infection control

Abstract

Introduction: Healthcare-associated infections (HAIs) remain a major cause of morbidity and mortality in pediatric intensive care units (PICUs), particularly in the context of increasing antimicrobial resistance. This study aimed to evaluate the incidence of HAIs, causative microorganisms, antimicrobial resistance patterns, and temporal trends over a nine-year period in the PICU of a tertiary care hospital.

Methodology: HAI data obtained through active surveillance between January 1, 2016, and December 31, 2024, were retrospectively analyzed. Patients who developed HAIs during their PICU stay were included. Diagnoses were established according to the National Healthcare-Associated Infections Surveillance Network (UHESA) criteria adapted from CDC definitions. Microorganisms were identified using the automated VITEK® 2 system (bioMérieux), and antimicrobial susceptibility testing was interpreted according to EUCAST criteria. Data were evaluated by calendar year and in three-year intervals.

Results: No statistically significant change in HAI incidence was observed over the nine-year period (p = 0.56). Gram-negative bacteria were the most frequently isolated pathogens, particularly Klebsiella pneumoniae and Pseudomonas aeruginosa. Among Gram-positive organisms, Staphylococcus aureus and coagulase-negative staphylococci predominated, while Candida species were the most common fungal isolates. The mortality rate among patients with HAIs was 44.7%, markedly higher than the overall PICU mortality rate (1.72%). Resistance rates increased notably, especially for carbapenems and colistin, whereas resistance to linezolid and vancomycin remained limited.

Conclusions: HAIs continue to represent a major clinical challenge in PICUs. Increasing resistance among Gram-negative pathogens highlights the urgent need for strengthened infection control strategies, continuous surveillance, and effective antimicrobial stewardship programs.

Author Biographies

Eren Çağan, Pediatric Infectious Diseases, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey

Dr. Eren Çağan is an Associate Professor of Pediatric Infectious Diseases at the University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital. He holds a PhD in Immunology and has extensive experience in pediatric infections, antimicrobial resistance, and hospital-acquired infections. His work focuses on improving infection control practices and understanding resistance trends in pediatric intensive care units.

 

Şeyma Nur Karataş, Department of Pediatrics, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey

Dr. Şeyma Nur Karataş is a specialist in Pediatrics at Yüksekova State Hospital, where she provides clinical care to infants, children, and adolescents. Her professional interests include pediatric infectious diseases, preventive pediatrics, and developmental follow-up. She is dedicated to improving child health through evidence-based practice and comprehensive family-centered care.

Begüm Bodur, Department of Pediatrics, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey

Dr. Begüm Bodur is a Pediatrician working at Kestel State Hospital. Her main areas of interest include childhood infections, growth and development, and preventive child healthcare.

Abdullah Taşdelen, Department of Pediatrics, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey

Dr. Abdullah Taşdelen is a Pediatric Infectious Diseases fellow at the Division of Pediatric Infectious Diseases, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital. His clinical and academic interests include healthcare-associated infections, antimicrobial resistance, and immunization practices in children. He is currently undergoing subspecialty training with a focus on pediatric infectious disease management and research.

Nevin Kiliç, Department of Pediatric Intensive Care Unit, Bursa Yüksek İhtisas Training and Research Hospital Bursa, Turkey

Dr. Nevin Kılıç is a Pediatrician with over 12 years of experience in pediatric intensive care. She currently works at the University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, providing critical care to infants and children with complex medical conditions. Her areas of interest include pediatric critical care, sepsis, and respiratory support.

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Published

2026-08-31

How to Cite

1.
Çağan E, Karataş Şeyma N, Bodur B, Taşdelen A, Kiliç N (2026) A nine-year surveillance of healthcare-associated infections in a pediatric Intensive Care Unit: epidemiology, pathogens, and antimicrobial resistance trends. J Infect Dev Ctries 20:1171–1178. doi: 10.3855/jidc.22442

Issue

Vol. 20 No. 08: August 2026

Section

Original Articles

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Copyright (c) 2026 Eren Çağan, Şeyma Nur KARATAŞ, Begüm Bodur, Abdullah Taşdelen, Nevin Kılıç

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