Dear Editor-in-Chief In a study conducted by WHO in 55 hospitals situated in 14 countries of the four regions of Europe, East Mediterranean, Southeast Asia, and Western Pacific, it was found that, on the average, 8.7% of hospitalized patients were afflicted with hospital-acquired infections. This study also revealed that more than 4.1 million people in the world suffer from hospital infections. The rate among ICU patients is 28%, compared with a 12% for overall hospital admissions…

Device-associated Nosocomial infection is a significant part of Nosocomial infection and can cause the majority of its mortality, morbidity, extra lengths of hospital stay and cost.In a 13-year review, the online database was searched for full articles to find research on epidemiology of device-associated Nosocomial infection in pediatric and neonatal wards.Twenty two papers were included; five articles report data both in pediatric and neonatal intensive care units. The maximum reported value per 1000 device day was in pediatric intensive care unit (36.5).The largest count of involved patients was 391527 in a Chinese trial and 4 were done multinational. Most papers were accomplished in the developing countries and showed that the rates of device-associated Nosocomial infection was decreased in before/after study by applying hygienic or educational interventions on safer care.Device-associated Nosocomial infections frequently occur in pediatric and neonatal intensive care units. This condition is preventable by the use of proper hygienic education and we need more attention on the prevention and diagnosis to reduce the rate of its complication, mortality and economic impact.

Background: Healthcare-associated infections such as Nosocomial infections (NI) are important causes of mortality worldwide. Objectives: In this study we evaluated the Nosocomial infections terms of microbiology (resistance, culturing, etc.) in a referral pediatric hospital based on national Nosocomial infection surveillance system.Patients and Methods: In an epidemiological surveillance study during a 14 month-period, patients who had no infection or not been in incubation period at the admission time, but had positive culture after the third day of admission, were defined as a case of Nosocomial infection. Characteristics and features of each infection were coded and classified.Results: The total number of hospitalized patients was 7730 and the total number of hospitalized days was 30147 days. The mean age of 103 patients with Nosocomial infection was 21.59±3.87 months and the average duration of hospital stay was 25.53 ±17.63 days. The incidence of NI was 1.33 per 100 hospital discharges and 0.34 per 100 hospital days. The incidence of NI was 1.33 infections per 100 hospital discharges and 0.34 infection per 100 hospital days. The most frequently isolated organisms included coagulase-negative Staphylococcus, Klebsiella, Serratia, yeast, E. coli and Pseudomonas respectively. The frequency of antimicrobial resistant isolated organisms was high. Half of isolated S. aureus were Methicillin resistant. Klebsiella was resistant to third generation Cephalosporins in 87%, against aminoglicosides in 80%, and against Imipenem in 52%.100% of isolated pseudomonas were resistant to third generation Cephalosporins and Imipenem.27 cases (of 103 cases) (26.2%) expired with the diagnosis of NI. Conclusions: Increasing frequency of anti-microbial resistant isolates emphasizes the necessity for bacteriological monitoring of hospitalized children.