Risk Factors for Neonatal Sepsis and Method for Reduction of Blood Culture Contamination

Abstract

BackgroundFalse-positive blood cultures findings may lead to a falsely increased morbidity and increased hospital costs. MethodThe survey was conducted as retrospective -prospective study and included 239 preterm infants (born before 37 weeks of gestation) who were treated in Neonatal Intensive Care Unit (NICU) in Institute for Child and Youth Health Care of Vojvodina during one year (January 1st, 2012 to December 31st, 2012). The retrospective part of the study focused on examination of incidence of neonatal sepsis and determination of risk factors. In the prospective part of the study infants were sub-divided into two groups: Group 1-infants hospitalized in NICU during the first 6 months of the study; blood cultures were taken by the ''clean technique'' and checklists for this procedure were not taken. Group 2-neonates hospitalized in NICU during last 6 months of the study; blood cultures were taken by ''sterile technique'' and checklists for this procedure were taken. ResultsThe main risk factors for sepsis were prelabor rupture of membranes, low gestational age, low birth weight, mechanical ventilation, umbilical venous catheter placement, and abdominal drainage. Staphylococcus aureus and coagulase negative Staphylococcus were the most frequently isolated microorganisms in false-positive blood samples. ConclusionsEducation of employees, use of checklists and sterile sets for blood sampling, permanent control of false positive blood cultures, as well as regular and routine monthly reports are crucial for successful reduction of contamination rates.

Bacteraemia and antibiotic sensitivity in a tertiary neonatal intensive care unit

“…Late onset sepsis was more common in our NICU, which differs from findings in other studies and raises concerns regarding adherence to infection prevention and control measures in our unit. 5,14 Adherence to infection prevention and control practices can be negatively affected by rapid turnover of beds and staff shortages, as well as other unit-specific conditions. These will need to be considered, and improvements will likely require a holistic approach to establish protocols targeting improved infection-control practices.…”

“…4 Coupled with invasive interventions often carried out in the NICU, this leaves neonates at a considerably high risk for sepsis. 4,5,6 Individual patient morbidity is not the only factor to consider. Neonates with suspected or proven sepsis require longer hospital stays, resulting in added cost and decreased turnover of beds.…”

“…With increasing resistance to penicillin and gentamycin, the need for information on local antibiotic susceptibility patterns is crucial. 3,5 The aim of this study was to determine the prevalence of positive blood cultures and describe the identified organisms and associated antibiotic susceptibility patterns in the NICU of a tertiary hospital. This will contribute towards the formulation of local empirical antibiotic regimens and will illustrate an approach that can be taken by other facilities.…”

The Relationship Between Congenital Hypothyroidism and Neonatal Sepsis in Premature Infants

“…Neonatal sepsis, yenidoğanda morbidite ve mortalitesinin en sık nedenlerinden biridir. Dünyada, yenidoğanda sepsis insidansı 1-10/1.000 canlı doğum insidansında görülmekte ve mortalitesi %15-50 arasında değişmektedir (11) . Prematüre bebeklerde term bebeklere göre sepsis insidansı 3-10 kat daha fazladır (12) .…”

“…Prematüre bebeklerde term bebeklere göre sepsis insidansı 3-10 kat daha fazladır (12) . Sepsis için membranların prematür rüptürü, düşük gebelik haftası (GH), düşük doğum ağırlığı (DA), mekanik ventilasyon, enteral beslenememe, parenteral beslenme, umblikal ve santral venöz kateter gibi risk faktörleri vardır (11) .…”