Occurrence of nosocomial bloodstream infections in six neonatal intensive care units

Brodie, Sharon B.; Sands, Kenneth; Gray, James E.; Parker, Robert A.; Goldmann, Donald A.; Davis, Roger B.; Richardson, Douglas K.

doi:10.1097/00006454-200001000-00012

Cited by 177 publications

(131 citation statements)

References 32 publications

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“…The previous reports, which were based on univariate analysis, suggested that lower birth weight and younger gestational age were associated with a higher risk of LNS. [8][9][10][11] After adjustment for the effects of the other variables by multivariate analysis, we found that there was no significant association between LNS and potential risk variables such as: birth weight r1500 g, gestation age r34 weeks, prenatal corticosteroid therapy, major congenital anomalies, patent ductus arteriosus, bronchopulmonary dysplasia, necrotizing enterocolitis, usage of UAC or percutaneous central venous catheter, mechanical ventilation, or parenteral nutrition therapy. This study agrees with the previous reports 12-14 that duration of UVC usage was independently associated with the development of LNS.…”

Section: Discussionmentioning

confidence: 83%

A Bedside Prediction-Scoring Model for Late-Onset Neonatal Sepsis

et al. 2005

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OBJECTIVE:Insufficient tools for bedside prediction of late-onset neonatal sepsis (LNS) initiated this study. The objective was to develop and validate a simple prediction-scoring model for LNS defined as culture-proven sepsis occurring 72 hours after birth. METHODS:The study was performed at a university hospital in Bangkok. The derivation phase included medical records of 1870 neonates, randomly selected from 9347 records of neonates who had been hospitalized for >72 hours during 1998 to 2000, of which 1824 records were available. In all, 100 neonates were clinically suspected of sepsis and 17 had proven LNS. The validation phase included 73 neonates suspected of having sepsis during July 2002to June 2003 and 25 who had LNS. Weighted coefficients from Cox's proportional hazards model and receiveroperating-characteristic (ROC) curve analysis were used. RESULTS:The incidence density of LNS was 17/11355 (1.5/1000) person-days. A scoring model was developed and consisted of the following: hypotension (score 4), abnormal body temperature (score 3), respiratory insufficiency (score 2), neutrophil band form fraction >1% (score 2), platelet count <150 Â 10 3 /ml (score 2), and umbilical venous catheterization (1 to 7 or >7 days; score 2 or 4). The area under the ROC curves for prediction of LNS in a neonate suspected of sepsis in each of the two phases was 0.85 and 0.80, respectively (p ¼ 0.436). The mean probabilities of LNS were approximately 0.10 (low risk) for scores from 0 to 3; 0.50 (intermediate risk) for scores from 4 to 6; and 0.70 (high risk) for scores Z7. CONCLUSION:A simple prediction-scoring model for LNS was developed. Validation of the scores suggested good diagnostic performance.

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Section: Discussionmentioning

confidence: 83%

A Bedside Prediction-Scoring Model for Late-Onset Neonatal Sepsis

et al. 2005

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“…1,2,6 S. epidermidis has been responsible for most cases to date. There have been few reports of human disease caused by S. capitis; most were cases of endocarditis in adults.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Coagulase-negative staphylococci are commensals of the skin and mucous membranes, and although they occasionally cause disease in humans, their virulence is usually limited. 2,3 They have caused a few cases of bacteremia, most notably in infants with central venous catheters or respiratory infections. 4 Because premature infants are fragile, they can exhibit severe symptoms in response to coagulase-negative infection.…”

Section: Introductionmentioning

confidence: 99%

Almond oil implicated in a Staphylococcus capitis outbreak in a neonatal intensive care unit

et al. 2007

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Objective: To develop an effective outbreak-control strategy by identifying the source and modes of transmission of Staphylococcus capitis in a 60-bed neonatal intensive care unit (NICU).Study Design: We conducted a study among neonates hospitalized during the outbreak (June 2000 through November 2003). All cases of S. capitis colonization or infection detected by clinical samples during the outbreak were included. The molecular analysis of the isolated was assessed by pulsed-field electrophoresis. We reported the description of the outbreak and the measures taken during this investigation.Result: Thirty-three patients were colonized or infected by S. capitis. Mean gestational age was 28.5±4.4 weeks of gestation, mean birth weight was 1068±637.3 g and the mean length of hospital stay was 77.9±35.9 days. We observed that positive S. capitis cultures were over-represented in six beds of the NICU. Because S. capitis is known to thrive in lipid media, we cultured samples from the almond oil bottles assigned to these beds. S. capitis strain recovered from one of the almond oil sample was genetically identical to the strain recovered from the cases. Conclusion:Almond oil is an unusual reservoir infection. Control policy allowed prompt institution of measures that were successful in ending the outbreak.

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“…This possible route of infection was not considered in a previous study that found a four-fold difference in CNSS rates between NICUs, which was not explained by known clinical risk factors. 7 While the rates of CNSS were higher for infants treated with OCs (27%) or nasal CPAP (21%) than for infants nursed in oxygen hoods (8%), the differences did not reach statistical significance, Figure 2. Cumulative percent of infants who ever had blood-tinged nasal secretions plotted against number of days on an OC.…”

Section: Discussionmentioning

confidence: 93%

Use of Oxygen Cannulas in Extremely Low Birthweight Infants is Associated with Mucosal Trauma and Bleeding, and Possibly with Coagulase-negative Staphylococcal Sepsis

Kopelman

Holbert

2003

J Perinatol

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Occurrence of nosocomial bloodstream infections in six neonatal intensive care units

Abstract: Neonatal NBSI incidence varies substantially among institutions despite adjustment for length of stay and some known risk factors. The uses of Broviac catheters and especially intravenous nutrition supplements were significant determinants of NBSI risk.

Cited by 177 publications

References 32 publications

A Bedside Prediction-Scoring Model for Late-Onset Neonatal Sepsis

A Bedside Prediction-Scoring Model for Late-Onset Neonatal Sepsis

Almond oil implicated in a Staphylococcus capitis outbreak in a neonatal intensive care unit

Use of Oxygen Cannulas in Extremely Low Birthweight Infants is Associated with Mucosal Trauma and Bleeding, and Possibly with Coagulase-negative Staphylococcal Sepsis

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