HEALTHCARE-ASSOCIATED INFECTIONS IN CHILDREN HOSPITALIZED IN A TERTIARY-LEVEL PEDIATRIC HEALTHCARE INSTITUTION IN THE REPUBLIC OF MOLDOVA

Rezumat

Introduction. Healthcare-associated infections (HAIs) represent a major public health problem in pediatrics, particularly among newborns and children requiring intensive or invasive care. Objectives. To evaluate the incidence, distribution, and microbiological profile of HAIs among children hospitalized in a tertiary-level pediatric healthcare institution in the Republic of Moldova.

Materials and methods. A retrospective descriptive study analyzed the medical records of children hospitalized between November 1, 2023, and May 5, 2024, in a tertiary-level pediatric healthcare institution in the Republic of Moldova. Of 1,163 records assessed, 96 were excluded due to incomplete medical records or missing relevant clinical information, hospitalization duration of less than 48 hours, illegible or insufficiently documented medical records, or the presence of an infection at the time of admission, resulting in a final sample of 1,067 pediatric patients. HAI case definitions followed Ministry of Health Order No. 533/2023. Data were analyzed in Microsoft Excel by calculating absolute and relative frequencies and incidence rates.

Results. A total of 67 patients (6.28%) developed at least one HAI, accounting for 77 HAI episodes in total. Accordingly, the episode-based incidence was 7.21 per 100 admissions, with the highest rates in the premature infants unit (25.37%, 34/134), neonatal pathology (19.04%, 16/84), and neonatal surgery (8.4%, 18/214). Newborns accounted for approximately 65% of all HAI episodes. Respiratory tract infections were the most frequent clinical form (54.6%), followed by bloodstream infections (19.5%). Gram-negative bacteria predominated (62% of isolates), particularly Klebsiella pneumoniae (24%) and Pseudomonas aeruginosa (11%); Gram-positive bacteria accounted for 31%, led by Staphylococcus epidermidis (14%).

Conclusions. Within the institution studied, HAIs remain an important pediatric problem, characterized by uneven distribution across departments and predominant involvement of newborns and premature infants; findings are limited to this institution and are not nationally representative.