Can we apply the European surveillance program of nosocomial infections (HELICS) to pediatric intensive care units?

To evaluate the applicability of the HELICS program [part of the “Improving Patient Safety in Europe” program aiming at controlling nosocomial infections (NI) through surveillance] in European pediatric ICUs.

A comparison of HELICS and pediatric definitions of the main NI was performed. The adaptability of the HELICS questionnaire for pediatric patients was examined. Then a European survey was carried out by e-mail questionnaire to analyze NI surveillance programs.

Units affiliated with the European Society of Paediatric and Neonatal Intensive Care or the French Groupe Francophone de Réanimation et Urgences Pédiatriques.

The main differences between adult and pediatric ICUs were the definition of ICU-acquired pneumonia, severity scores at admission, and scores of risk for NI. A total of 65 answers from 23 countries were collected. Among them 56 had a NI surveillance program that was of local origin for 64%. The most frequently collected NI were blood stream infections (91% of the units), catheter-related infections (88%), acquired pneumonia (86%), and urinary tract infections (77%). Definitions of NI had a local-based origin in 18% of cases, a regional-based or nation-wide origin in 21%, came from the Centers for Disease Control and Prevention in 38% and had multiple origins in 20%. Seventy-five percent of the units declared an interest in joining a European pediatric working group on NI within the European Society of Paediatric and Neonatal Intensive Care.

The adaptation of the HELICS protocol for pediatric ICUs is necessary. Its application is largely wished and may be easily performed.