Nosocomial urinary tract infections in children in a pediatric intensive care unit: A follow-up after 10 years
Bibliographic record
Abstract
OBJECTIVE: To define nosocomial urinary tract infection (NUTI) rates in a pediatric intensive care unit, and determine whether practice recommendations have been sustained after 10 yrs. DESIGN: Retrospective, descriptive observational study followed by point prevalence audits of duration of urinary tract catheterization. SETTING: A 32-bed pediatric intensive care unit in a multidisciplinary, 300-bed, university-affiliated tertiary care hospital. SUBJECTS: The retrospective review included patients admitted to the pediatric intensive care unit between December 1997 and July 1999 who developed a NUTI. The audits of duration of urinary tract catheterization were performed in December 2001. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The primary outcome measure was the development of NUTI. Out of 2,832 consecutive admissions, 25 patients developed 27 episodes of NUTI (rate, 0.95/100 admissions). Previous surgery for congenital heart disease was the primary risk factor for NUTI. All 18 patients for whom the duration of catheterization was available had been catheterized for at least 3 days. Gram-negative bacilli and yeast accounted for 82% of NUTI pathogens. Twenty percent of bacterial pathogens were antibiotic resistant. Audits of the duration of urinary tract catheterization done on five separate occasions revealed that the mean duration of catheterization ranged from 3.5 to 4.7 days, with a peak absolute value of 16 days. CONCLUSIONS: NUTIs in children in our pediatric intensive care unit were associated with previous cardiovascular surgery and with urinary tract catheterization of at least 3 days. The need for careful fluid monitoring by catheterization must be balanced against the increased risk of catheter-related urinary tract infection. Removal of urinary catheters at the earliest opportunity will prevent many infections. Ongoing education or innovative strategies will be required to sustain optimal practice.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".