Management of outbreaks in neonatal intensive care units

Decembrino, Lidia; Maini, Antonella; Decembrino, Nunzia; Maggi, Ivana; Lacerenza, Serafina

doi:10.1016/s0378-3782(14)70018-0

Cited by 16 publications

(16 citation statements)

References 17 publications

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“…Moreover, the decreasing number of cross-colonized patients during this study probably reflects the healthcare workers' infection control measures compliance [4]. Despite ideal recommendations [11], staff cohorting was not possible in our NICU due to limited human resources. Cross-transmission seemed to be the most probable form of colonization in our NICU, also as reported by other authors [6].…”

Section: Discussionmentioning

confidence: 94%

“…Definition of an outbreak included two or more sterile site isolates of the same species, with the same antibiogram, from different patients, within a period of two weeks. Alert should be triggered when there is either a case of three or more babies colonized with the same Gram-negative bacteria (in NICUs that routinely screen for colonization), a single case of a rare or never seen Gram-negative bacteria, or a single systemic infection with an ESBL-producing or carbapenemase-producing Gram-negative bacteria [11,13]. Imported cases were defined as positive swabs within the first 48 h after readmission.…”

Section: Methodsmentioning

confidence: 99%

“…Neonatal risk factors for intestinal CPE colonization and infection have been inconsistently described in the literature, and these are mainly derived from adult studies [1]. Features reported include low gestational age, low birth weight, intensive care unit stay, prolonged hospitalization, prior exposure to antibiotics (especially carbapenems), invasive medical procedures or devices, history of surgery, congenital/syndromic conditions leading to impaired functional status and/or immunosuppression, lack of breastfeeding, maternal-to-neonatal transmission, and travel from endemic regions [1,6,[9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…NICU outbreaks may have serious neonatal implications, and thus maintaining a high level of suspicion is crucial for prompt identification and outbreak control [7,12]. An outbreak in an NICU should be suspected when there are at least two newborns colonized with the same species, a single case of a rare Gram-negative bacteria identification, or a single systemic infection with an extended-spectrum β-lactamase producing or carbapenem-resistant Gram-negative bacteria [11,13].…”

Section: Introductionmentioning

confidence: 99%

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Carbapenemase-Producing Enterobacteriaceae (CPE) Newborn Colonization in a Portuguese Neonatal Intensive Care Unit (NICU): Epidemiology and Infection Prevention and Control Measures

Almeida

Mendo

Costa

et al. 2021

Infectious Disease Reports

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Infections due to carbapenemase-producing Enterobacterales (CPE) are increasing worldwide and are especially concerning in a neonatal intensive care unit (NICU). Risk factors for CPE gut colonization in neonates need to be clarified. In this work, we describe the epidemiological and clinical features of CPE-colonized newborns and the infection control measures in a Portuguese NICU. We performed a prospective, observational, longitudinal, cohort study for surveillance of CPE colonization. Maternal and neonatal features of colonized newborns and surveillance strategy were described. A statistical analysis was performed with SPSS23.0, and significance was indicated by p-value ≤ 0.05. Between March and November 2019, CPE was isolated in 5.8% of 173 admitted neonates. Carbapenemase-producing Klebsiella pneumoniae were the most frequently isolated. There was no associated infection. Birth weight, gestational age, length of stay, and days of central line were the identified risk factors for CPE colonization (bivariate analysis with Student’s t-test or Mann–Whitney U test, according to normality). No independent risk factors for CPE colonization were identified in the logistic regression analysis. CPE colonization risk factors are still to be determined accurately in the neonatal population. Active surveillance and continuous infection control measures restrained the current cluster of colonized newborns and helped to prevent infection and future outbreaks.

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Section: Discussionmentioning

confidence: 94%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Carbapenemase-Producing Enterobacteriaceae (CPE) Newborn Colonization in a Portuguese Neonatal Intensive Care Unit (NICU): Epidemiology and Infection Prevention and Control Measures

Almeida

Mendo

Costa

et al. 2021

Infectious Disease Reports

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“…Infected HCWs might spread pathogenic microorganisms in NICUs [8]. These situations also increase the risk of HAIs in those infants [9]. To minimize outbreaks in the NICU, each newborn should be treated as if it contains unique flora colonies that should not be transferred to other neonates [10].…”

Section: Introductionmentioning

confidence: 99%

Effect of camera monitoring and feedback along with training on hospital infection rate in a neonatal intensive care unit

Karabay

Kaya

Hafızoğlu

et al. 2019

Ann Clin Microbiol Antimicrob

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BackgroundIn terms of pediatric healthcare-associated infections (HAI), neonatal intensive care units (NICU) constitute the greatest risk. Contacting a health care personnel, either directly or indirectly, elevates NICU occurrence rate and risks other infants in the same unit. In this study, it is aimed to retrospectively analyze the effect of the training along with camera monitoring and feedback (CMAF) to control the infection following a small outbreak.MethodsESBL producing Klebsiella pneumoniae was detected on three infants in May 2014 at the isolation room of Sakarya University Hospital NICU. Precautions were taken to prevent further spread of the infection. The infected infants were isolated and the decolonization process was initiated. For this aspect, health care workers (HCWs) in NICU were trained for infection control measures. An infection control committee has monitored the HCWs. Before monitoring, an approval was obtained from the hospital management and HCWs were informed about the CMAF, who were then periodically updated. On a weekly basis, NICU workers were provided with the feedbacks. Epidemic period and post-epidemic control period (June–July–August 2014) were evaluated and p value < 0.05 was considered statistically significant.ResultsHealthcare-associated infection (HAI) density was 9.59% before the onset of the CMAF, whereas it was detected as 2.24% during the CMAF period (p < 0.05). Following the precautions, HAI and HAI density rates have reduced to 76.6% and 74.85%, respectively. Moreover, hand hygiene compliance of health care workers was found 49.0% before the outbreak, whereas this rate has elevated to 62.7% after CMAF.ConclusionsHealthcare workers should be monitored in order to increase their compliance for infection control measures. Here, we emphasized that that CMAF of health workers may contribute reducing the HAI rate in the NICU.

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Outbreak Control in the Nursery

Cantey

2018

Neonatal Infections

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Management of outbreaks in neonatal intensive care units

Cited by 16 publications

References 17 publications

Carbapenemase-Producing Enterobacteriaceae (CPE) Newborn Colonization in a Portuguese Neonatal Intensive Care Unit (NICU): Epidemiology and Infection Prevention and Control Measures

Carbapenemase-Producing Enterobacteriaceae (CPE) Newborn Colonization in a Portuguese Neonatal Intensive Care Unit (NICU): Epidemiology and Infection Prevention and Control Measures

Effect of camera monitoring and feedback along with training on hospital infection rate in a neonatal intensive care unit

Outbreak Control in the Nursery

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