Prospective Surveillance of Nosocomial Infections in a Swiss NICU: Low Risk of Pneumonia on Nasal Continuous Positive Airway Pressure?

Hentschel, Juliane; Brüngger, Beat; Stüdi, K.; Mühlemann, Kathrin

doi:10.1007/s15010-005-5052-x

Cited by 34 publications

(15 citation statements)

References 24 publications

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“…In our study, neonates with CVC complicated by CLABSI predominantly had intestinal diseases and required parenteral nutrition (table 3). This is in accordance with previously identified risk factors for CLABSI, such as parenteral nutrition with lipid infusion, young age, and prematurity and/or low birth weight 13–15…”

Section: Discussionsupporting

confidence: 92%

Prospective study on central venous line associated bloodstream infections

Wagner

Bonhoeffer

Erb

et al. 2011

Archives of Disease in Childhood

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Section: Discussionsupporting

confidence: 92%

Prospective study on central venous line associated bloodstream infections

Wagner

Bonhoeffer

Erb

et al. 2011

Archives of Disease in Childhood

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“…52 Thirdly, noninvasive respiratory support preserves normal laryngeal function, allows normal mucociliary clearance of lung secretions, and may prevent secondary lung damage by reducing the incidence of ventilatorassociated pneumonia. 44,53 Effect on IVH Avoiding eMV in very premature infants means that a considerable number of them will later need rescue intubation because of hypercapnic respiratory failure. On the one hand, there are substantiated concerns about the association between hypercapnia and IVH in preterm infants, 54 especially during the first days of life.…”

mentioning

confidence: 99%

Avoiding Endotracheal Ventilation to Prevent Bronchopulmonary Dysplasia: A Meta-analysis

2013

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Avoiding Endotracheal Ventilation to Prevent Bronchopulmonary Dysplasia: A Meta-analysis abstract BACKGROUND AND OBJECTIVE: Mechanical ventilation via an endotra-cheal tube is a risk factor for bronchopulmonary dysplasia (BPD), one of the most common morbidities of very preterm infants. Our objective was to investigate the effect that strategies to avoid endotracheal mechanical ventilation (eMV) have on the incidence of BPD in preterm infants ,30 weeks' gestational age (GA). METHODS: In February 2013, we searched the databases Medline, Embase, and the Cochrane Central Register of Controlled Trials. Study selection criteria included randomized controlled trials published in peer-reviewed journals since the year 2000 that compared preterm infants ,30 weeks' GA treated by using a strategy aimed at avoiding eMV with a control group in which mechanical ventilation via an endotracheal tube was performed at an earlier stage. Data were extracted and analyzed by using the standard methods of the Cochrane Neonatal Review Group. The authors independently assessed study eligibility and risk of bias, extracted data and calculated odds ratios and 95% confidence intervals, employing RevMan version 5.1.6. RESULTS: We identified 7 trials that included a total of 3289 infants. The combined odds ratio (95% confidence interval) of death or BPD was 0.83 (0.71-0.96). The number needed to treat was 35. The study results were remarkably homogeneous. Avoiding eMV had no influence on the incidence of severe intraventricular hemorrhage.

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“…This likely explains the lower risk of health care-associated pneumonia in neonates using nasal CPAP versus those treated with endotracheal intubation (1.8 vs 12.8 per 1000 nasal CPAP or ventilator days). 21 However, CPAP has been associated with an increased risk of Gram-negative infections. 22 Skin and soft tissue infections are commonly observed in NICU patients.…”

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confidence: 99%

Epidemiology and Diagnosis of Health Care–Associated Infections in the NICU

Polin¹,

Denson²,

Brady³

et al. 2012

Pediatrics

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Health care−associated infections in the NICU are a major clinical problem resulting in increased morbidity and mortality, prolonged length of hospital stays, and increased medical costs. Neonates are at high risk for health care−associated infections because of impaired host defense mechanisms, limited amounts of protective endogenous flora on skin and mucosal surfaces at time of birth, reduced barrier function of neonatal skin, the use of invasive procedures and devices, and frequent exposure to broad-spectrum antibiotics. This statement will review the epidemiology and diagnosis of health care−associated infections in newborn infants. Pediatrics 2012;129:e1104-e1109 INTRODUCTIONHealth care−associated infections are infections acquired in the hospital while receiving treatment of other conditions. They are common occurrences in patients of all ages and are estimated to result in 2 million infections, 90 000 deaths, and $28 to $45 billion in excess health care costs annually. 1,2 In the Pediatric Prevention Network national point prevalence survey, 11.2% of NICU patients had a health care−associated infection on the day of the survey. 3 Although there are no recent estimates of the cost of health care−associated infections in the NICU, Payne et al 4 estimated that health care-associated bloodstream infections added almost $100 million to the cost of treating infants with birth weights from 500 to 1499 g in 1999 dollars. Because this finding represented the excess costs associated with only one type of infection in one gestational age cohort, it provides just a glimpse of the financial impact of health care−associated infections in the NICU. This financial estimate does not include the potential morbidity and mortality concerns for the infant and the effect that the prolonged hospital stay has on the family and resource utilization within the hospital. Reducing health care−associated infections in the NICU would have benefits to infants, families, and the health care delivery system. The purpose of this technical report was to review the epidemiology and diagnosis of health care-associated infections in the NICU. A companion policy statement addresses strategies for the prevention of health care-associated infections. EPIDEMIOLOGYNewborn infants hospitalized in a NICU have host factors that not only make them more vulnerable to acquisition of health care-associated infections but also increase their risk of developing more serious illnesses. Whether an infant is born preterm or at term, many components of their innate and adaptive immune systems exhibit diminished function when compared with older children and adults. Infants with birth weights less than1500 g (very low birth weight) have rates of health care-associated infections 3 times higher than those who weigh greater than 1500 g at birth. However, the increased susceptibility to infection in infants of very low birth weight is multifactorial and related to both the developmental deficiencies in the innate and adaptive immune systems and a greate...

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Prospective Surveillance of Nosocomial Infections in a Swiss NICU: Low Risk of Pneumonia on Nasal Continuous Positive Airway Pressure?

Cited by 34 publications

References 24 publications

Prospective study on central venous line associated bloodstream infections

Prospective study on central venous line associated bloodstream infections

Avoiding Endotracheal Ventilation to Prevent Bronchopulmonary Dysplasia: A Meta-analysis

Epidemiology and Diagnosis of Health Care–Associated Infections in the NICU

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