HealthCare-associated Infections in a Neonatal Intensive Care Unit in Turkey in 2008: Incidence and Risk Factors, A Prospective Study

Abstract

In this study, we have prospectively recorded healthcare-associated infections (HAIs) in NICU and found incidence density as 18 infections per 1000 patient days. Of the infections, 51.3% was bacteriemia (BSI), and 45.1% was ventilator-associated pneumonia (VAP). Gram-negative microorganisms were predominant in VAP and Staphylococcus epidermidis was the leading microorganism (53.0% of BSIs) in BSIs. Multivariate logistic regression analysis showed the importance of hood O(2) use in days (RR: 1.3) and total parenteral nutrition use in days (RR: 1.09) for BSIs. Umbilical arterial catheterization in days (RR: 1.94), ventilator use in days (RR: 1.05), chest tube (RR: 12.55), orogastric feeding (RR: 3.32) and total parenteral nutrition in days (RR: 1.05) were found to be significantly associated with VAP. In conclusion, incidence density in our unit is high and Gram-negative rods are predominant similar to developing countries. These results strongly suggest improving measures of prevention and control of HAIs in the unit.

Yenidoğan yoğun bakım biriminde hastane kökenli kan akım enfeksiyonları

“…In our study, the rate of cathether related bloodstream infection was found to be 9,6:1000 days. It was noted that this rate was lower than the rate found in the study performed in our country by Yap›c›o¤lu et al (18). It was found that nasocomial infection was observed 2,46 fold more frequently when cathether was used in term babies and 3,1 fold more frequently when cathether was used in preterm babies.…”

“…In the NNIS (National Nasocomial Infections Surveillance in USA) study, the rate of bloodtream infection caused by use of cathether was found to be 3.5-9.1: 1000 days (19). In the prospective studies performed by Perlman et al (20) in two NICU's, In the USA National Hospital study, the rate of cathether related bloodstream infection was reported to be 7.4-16.1: 1000 days in newborns between 1000 and 2500g for 90th percentile (18). In our study, the rate of cathether related bloodstream infection was found to be 9,6:1000 days.…”

“…The rate found in our study was noted to be higher than the 90th percentile which was considered to be the highest value. In another study performed in our country by Yap›c›o¤lu et al (18), a more higher value was found. We believe this is related to the fact that our unit has a high patient load and nurse-patient ratio is low.…”

“…Babazono et al (17) reported that gestational age, cathether use and mechanical ventilation were related to nasocomial infection in an infection survaillence study which included seven centers. In the prospective study performed by Yap›c›o¤lu et al (18), use of total parenteral nutrition, cathether, ventilator and chest tube were found to be risk factors. In our study, we found that hospitalization period, use of intubation, use of mechanical ventilation and use of cathether were significant risk factors in term and preterm babies who developed nasocomial infection.…”

“…In the NNIS (National Nasocomial Infections Surveillance in USA) study, the rate of VRP for 2002-2004 was reported to be 1.4-3.5:1000 days (19). Yap›c›o¤lu et al (18) reported the rate of VRP to be 28.1:1000 days in 2008. According to the surveillance report the rate of VRP was reported to be 3.2-8.5:1000 days for the 90th percentile (19).…”