388. Epidemiology of Healthcare-associated Infections in Pediatric Long-term Care Facilities
Session: Poster Abstract Session: HAI: Pediatrics
Thursday, October 27, 2016
Room: Poster Hall
  • Maykowski_IDWeek Poster final.pdf (446.4 kB)
  • Background:

    Healthcare-associated infections (HAIs) cause morbidity and mortality in residents of pediatric long-term care facilities (pLTCFs), but few data are available that describe the epidemiology of HAIs in this population. We performed a multicenter study to [1] describe the types and rates of HAIs diagnosed in residents of pLTCFs and [2] identify potential risk factors for respiratory tract infections (RTIs).


    We conducted prospective surveillance for HAIs in 3 pLTCFs (54, 97, and 137 beds) from Sept. 2012 - Dec. 2015. HAIs were defined as those diagnosed by treating clinicians. HAI rates per 1000 resident-days were calculated. Risk factors associated with having at least one RTI were identified and characterized through multivariable logistic regression adjusted for site, age, devices, and number of chronic comorbid conditions (CCCs).


    During the study period, 717 residents < 21 years of age (median 5.3 years) were enrolled. Overall, 64% had > 4 chronic comorbid conditions (CCCs), most commonly neurologic and respiratory conditions; 59% had feeding tubes; 30% had tracheostomies; and 5.2% had central lines. Of the 2,052 HAIs diagnosed, 63% were RTIs (n=1294). A viral pathogen was detected in 54% of RTIs (n=698), and 49% of all residents were diagnosed with at least one RTI. Other HAIs included: conjunctivitis (6% of HAIs), as well as skin and soft tissue (6%), urinary tract (4%), gastrointestinal (4%), and bloodstream infections (3%). The overall HAI rate was 5.3 HAIs per 1000 resident-days. The RTI rate was 3.3 RTIs per 1000 resident-days which ranged from 2.1 to 7.1 per 1000 resident-days among the sites. Feeding tubes (p=0.0003), tracheostomies (p<0.0001), and number of CCCs (p=0.0306) were significant risk factors for RTIs when adjusting for age, site, and devices.


    A unique HAI profile was identified in this study for the pediatric LTC population, both in terms of HAI types and rates, when compared to pediatric acute care and adult LTC populations. RTIs associated with respiratory viruses were the most common HAIs. Future work should focus on infection prevention and control strategies to reduce HAIs, particularly RTIs, in this unique population.

    Philip Maykowski, BS, MPH1,2, Meghan Murray, MPH3, Bevin Cohen, MPH, MPhil4, Natalie Neu, MD5, Gordon Hutcheon, MD6, Edwin Simpser, MD7, Haomiao Jia, PhD8, Luis Alba, BS9, Elaine Larson, RN, PhD4 and Lisa Saiman, MD, MPH, FSHEA10, (1)Department of Pediatrics, Columbia University Medical Center, New York, NY, (2)Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, (3)School of Nursing, Columbia University Medical Center, New York, NY, (4)Columbia University School of Nursing, New York, NY, (5)Department of Pediatrics, Columbia University Medical Center, New York City, NY, (6)Elizabeth Seton Pediatric Center, South Yonkers, NY, (7)St. Mary’s Healthcare System for Children, Bayside, NY, (8)Biostatistics, Columbia University Mailman School of Public Health, New York, NY, (9)Columbia University Medical Center, New York, NY, (10)Pediatrics, Columbia University Medical Center, New York, NY


    P. Maykowski, None

    M. Murray, None

    B. Cohen, None

    N. Neu, None

    G. Hutcheon, None

    E. Simpser, None

    H. Jia, None

    L. Alba, None

    E. Larson, None

    L. Saiman, None

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