Hospital-associated infections in children: a prospective post-discharge follow-up survey in three different paediatric hospitals S. Kinnula a , M. Buettcher b , T. Tapiainen a, * , M. Renko a , K. Vepsa ¨la ¨inen c , R. Lantto c , U. Heininger b , M. Uhari a a Department of Pediatrics, University of Oulu, Finland b University Children’s Hospital, Basel, Switzerland c North Karelia Central Hospital, Joensuu, Finland A RT IC L E I N F O Article history: Received 29 March 2011 Accepted 25 September 2011 by J.A. Child Available online 5 November 2011 Keywords: Children Healthcare-associated infection Viruses S U M M A RY Background: Reported viral hospital-associated infection (HAI) frequencies have ranged from 1% to 24% between paediatric wards and hospitals. Reasons for this variation remain unclear. Aim: To evaluate the rate of viral HAIs and risk factors in three different paediatric hospitals. Methods: Data were collected prospectively for two years in one infectious disease ward and three general paediatric wards in Finland and Switzerland. Infections were recorded during the hospitalization and one week after discharge. Ward-specific risk factors for HAIs within each ward were searched by using multivariate logistic regression analysis. Findings: Altogether 5119 patients were hospitalized. Total HAI frequency was 12.2%, with 2.4% of the patients developing HAI in hospital, most often gastroenteritis, and 9.8% [95% confidence interval (CI): 8.9e10.8%] within 72 h of discharge. HAI rates varied from 5.8% to 17.1% between the wards, the highest rate being in a general paediatric ward where shared rooms were common and active cohorting according to viral aetiology was not done. Shared room (OR: 5.45; 95% CI: 2.44e12.2 in a general ward treating infants), longer hospitalization (OR: 1.42 per day; 95% CI: 1.20e1.67 in an infectious disease ward) and young age (OR: 0.71 per year; 95% CI: 0.51e0.98 in general paediatric ward for children aged >1 year) increased risk of HAI in hospital. Conclusion: Most viral HAIs in paediatric wards become evident after discharge. Single room bedding appears to be effective in preventing HAIs, especially the spread of respiratory viruses. It also appears that caring for patients with contagious diseases in a separate unit is advantageous. Ó 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved. Introduction Viruses, especially gastrointestinal and respiratory viruses, spread easily in paediatric wards, causing hospital-associated infections (HAIs), as viral diseases are common causes of hospitalization in children. 1e6 A previous survey found that * Corresponding author. Address: Department of Pediatrics, University of Oulu, Box 5000, 90014 University of Oulu, Finland. Tel.: þ358 8 315 5185; fax: þ358 8 315 5559. E-mail address: terhi.tapiainen@oulu.fi (T. Tapiainen). Available online at www.sciencedirect.com Journal of Hospital Infection journal homepage: www.elsevierhealth.com/journals/jhin 0195-6701/$ e see front matter Ó 2011 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jhin.2011.09.007 Journal of Hospital Infection 80 (2012) 17e24