Background: Septicemias comprise more than one third of nosocomial infections in children. Their risk factors are related with the exposition time, therefore they are evaluated in relationship to it.
Patients and methods: Prospective observational study along 4 years in surgical children and in those entered in the Internal Medicine Unit patients of a children Hospital, with stays higher than two days. Data were collected from admission to discharge. Bivariant analysis of stay time until infection with Wilcoxon-Gehan test, followed by Cox regression with time interaction terms for the risk factors that did not fulfill the requisite of proportional risks.
Results: 4,098 children were studied. 3.8% suffered primary septicemia and more than one half had coagulase-negative staphylococci. Cox regression showed the following risk factors: type of surgery, peripheral and central venous catheter, urinary catheterization, stay previous to surgery and duration of intervention. The protection factors were more than 3 days of antibiotherapy, age higher than 1 year and male sex. The factors with interaction with time were: stay previous to surgery, sex and duration of intervention.
Conclusions: The stay previous to surgery, antibiotherapy reduction and duration of instrumentations are risk factors susceptible to be modified in order to reduce the incidence of infection in children. Protection by means of antibiotics requires to be evaluated through an ad hoc designed study.