Bloodstream Infection in Children Managed at a Tertiary Hospital in Oman

Abstract

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.