Retrospective study: China's pediatric hospital infections before and during the COVID-19 pandemic

Abstract

Introduction: The COVID-19 pandemic probably influenced the incidence of healthcare-associated infections (HAIs) in pediatric hospitals. This study aimed to assess HAIs and the impact of multidrug-resistant organisms in pediatric intensive care units (ICUs) before and during the pandemic.

Methodology: This retrospective study was conducted at the Children's Hospital of Soochow University from January 2017 to December 2022, covering various ICU units. Statistical analyses compared HAI rates, including Ventilator-associated pneumonia (VAP), central line-associated bloodstream infections (CLABSI), and catheter-associated urinary tract infections (CAUTI), and the prevalence of multidrug-resistant pathogens.

Results: Child hospital admissions were analyzed, with 185,116 admissions pre-pandemic and 218,681 during the pandemic. The average length of stay (LOS) increased across ICU units. Overall, the HAI rates declined from 2.7 to 1.79 (p < 0.01) with NICU rates decreasing from 2.93 to 2.07 (p < 0.01) and SICU rates from 7.17 to 4.56 (p < 0.01) except for general ICUs. VAP rates declined in the general ICU and NICU, while the rates in the SICU remained statistically unchanged. The CLABSI and CAUTI rates remained stable across all ICUs. The total count of multidrug-resistant bacteria increased by 41 instances with significant increases in gram-negative bacteria, particularly CRPA (13%) and CRAB (3%), while MRSA decreased by 12%. CRE strains decreased by 10 counts in the NICUs, while CRAB increased by 12 in the general ICUs and by 8 in the SICUs.

Conclusions: This study reveals a significant HAI decline in pediatric hospitals during the pandemic, suggesting implications for pediatric ICU infection control.