Bloodstream Infection in Children Managed at a Tertiary Hospital in Oman.

OBJECTIVES

This study aimed to assess the local epidemiology and outcome of bloodstream infection (BSI) among Omani children.

METHODS

This retrospective study was conducted at Sultan Qaboos University Hospital, Muscat, Oman, over 5 years (2014-2018) and included laboratory-confirmed BSI among children aged 0-12 years old. Patients' demographic, clinical and laboratory data were extracted from the hospital's electronic records and used to assess BSI rates and outcomes.

RESULTS

A total of 1,253 positive blood cultures were identified, of which 592 (47.2%) were regarded as contaminants. Overall, 404 (32.2%) significant episodes of BSI were identified in 272 patients; 346 (85.6%) significant episodes were in children aged ≤5 years and 366 (90.6%) had comorbidities. The 5-year incidence of BSI was 13 per 1,000 admissions. Furthermore, 333 (82.4%) episodes were healthcare-related infections. Enterobacterales (n = 152; 37.6%) were the most common organisms identified followed by coagulase-negative staphylococci (n = 63; 15.6%). Approximately 40% of Gram-negative organisms were resistant to third-generation cephalosporins. The crude mortality rate at 30 days was 9.2%. Paediatric intensive care unit admission (crude odds ratio [COR] = 2.24, 95% confidence interval [CI]: 0.98-4.78) and the presence of graft-versus-host disease (COR = 7.99, 95% CI: 1.52-37.76) were associated with increased death within 30 days. The multivariate logistic regression analysis showed that Pseudomonas aeruginosa (adjusted odds ratio = 18.46, 95% CI: 3.96-97.84) was the only independent predictor of increasing 30-day mortality in this cohort.

CONCLUSION

A high rate of hospital-related BSI was found in children in Oman, highlighting the need to optimise infection control strategies and the care of central vein access devices.