Healthcare-Associated Infections in Children

With advances in technology and medical science, children with previously untreatable and often fatal conditions, such as congenital heart disease, extreme prematurity and pediatric malignancy, are living longer.  While this is a tremendous achievement, pediatric providers are now more commonly facing challenges in these medical complex children both as a consequence of their underlying disease and the delivery of medical care.  The term healthcare-associated infections (HAIs) encompass both infections that occur in the hospital and those that occur as a consequence of healthcare exposure and medical complexity in the outpatient setting.  HAIs are associated with substantial morbidity and mortality for the individual patient as well as seriously taxing the healthcare system as a whole.  In studies from the early 2000s, over 11% of all children in pediatric intensive care units develop HAIs and this figure increases substantially if neonatal intensive care units are considered.  While progress has been made in decreasing the rates of HAI in the hospital, these infections remain a major burden on the medical system.  In a study published in 2013, the annual estimated costs of the five most common HAIs in the United States totaled $9.8 billion.  An estimated 648,000 patients developed HAIs in hospitals within the US in 2011 and children with healthcare-associated bloodstream infection have a greater than three-fold increased risk of death.

While a number of texts discuss HAIs in the broader context of infectious diseases or pediatric infectious diseases (such as Mandell's Principles and Practice of Infectious Diseases or Long and Pickering's Principles and Practice of Pediatric Infectious Diseases) no single text specifically focuses on the epidemiology, diagnosis and management of HAI in children.  Many infectious diseases texts are organized based on the microbiology of infection and from this starting point then