Prevention of healthcare-associated infections in neonates: room for improvement

Abstract

Infants in neonatal intensive care units (NICUs) are highly susceptible to infection due to the immaturity of their immune systems. Healthcare-associated infections (HCAIs) are associated with prolonged hospital stay, and represent a significant risk factor for neurological development problems and death. Improving HCAI control is a priority for NICUs. Many factors contribute to the occurrence of HCAIs in neonates such as poor hand hygiene, low nurse-infant ratios, environmental contamination and unnecessary use of antibiotics. Prevention is based on improving neonatal management, avoiding unnecessary use of central venous catheters, restricting use of antibiotics and H2 blockers, and introducing antifungal prophylaxis if necessary. Quality improvement interventions to reduce HCAIs in neonates seem to be the cornerstone of infection control.

Blood contamination in neonates: clinicians' dilemma

“…CoNS colonization of neonates in the hospital environment occurs horizontally by parents and staff and transmission of endemic strains by hospital staff can lead to their circulation for extended periods. 18 In spite of microbiological advances, there are no consensus on definitions and practices with CoNS infection among the clinicians thus resulting in over presentation of CoNS as true pathogen. 3 Further multicentric large sample size, case control studies are needed to develop clinical predictability scoring to identify CoNS true infection so that it can be treated wisely and cost effectively which can reduce the exciting dilemma.…”

Risk factors associated with nosocomial infections in the Neonatal Intensive Care Unit at Mahatma Gandhi Memorial hospital between 2014 and 2015

“…15 Health-care associated infections represent a significant factor for neurological complications and death, which is aggravated by an inevitable prolonged hospital stay. 16 An estimated 85% of all neonatal intensive care units (NICU) harbour nosocomial pathogens due to transgressions of infection prevention and control (IPC) principles. 17 Transmission via hands may promote endemic strains of pathogenic organisms that remain viable for a period of time.…”

“…17 Transmission via hands may promote endemic strains of pathogenic organisms that remain viable for a period of time. 16 Neonates in NICU are exposed to specific and non-specific risk factors which increase the risk of bacterial and fungal sepsis, 16 including the recurrent use of broad-spectrum antimicrobial drugs, parental nutrition, acid inhibitor and steroids. Environmental risk factors associated with the transmission of infections are significant and related to seasonal changes.…”

Assessing the accuracy of the National Neonatal Audit Programme calculated central line-associated bloodstream infection rate from local data

“…Neonatal central line-associated bloodstream infections (CLABSI) prolong hospital stay, cause worse neurodevelopmental outcomes including cerebral palsy and increase mortality 1. More premature infants are at increased risk and often require central lines for longer.…”