Risk factors and lethality of laboratory-confirmed bloodstream infection caused by non-skin contaminant pathogens in neonates

Romanelli, Roberta Maia de Castro; Anchieta, Lêni Márcia; Mourão, Maria Vitória Assumpção; Campos, Flávia Alves; Loyola, Flavia C.; Mourão, Paulo Henrique Orlandi; Armond, Guilherme Augusto; Clemente, Wanessa T.; Bouzada, Maria Cândida Ferrarez

doi:10.1016/j.jped.2013.03.002

Cited by 26 publications

(16 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…18 Premature infants are at increased risk of infection because of immature immune function, 4 invasive procedures including placement and subsequent use of central venous lines, 19 mechanical ventilation, and parenteral nutrition. A point prevalence analysis found that 11% of NICU patients had a nosocomial infection, and 50% of those were BSI.…”

Section: Discussionmentioning

confidence: 99%

Sustained Reduction in Bloodstream Infections in Infants at a Large Tertiary Care Neonatal Intensive Care Unit

Neill

Haithcock

Smith

et al. 2016

Advances in Neonatal Care

View full text Add to dashboard Cite

Purpose Reduction of bloodstream infections (BSI) has emerged as an important patient safety goal. Implementation of central line insertion bundles, standardized line care protocols, and health care provider education programs have reduced BSI in neonatal intensive care units (NICUs) around the country. The ability of large tertiary care centers to decrease nosocomial infections, including BSI, has been demonstrated. However, long-term BSI reductions in infants are not well documented. We sought to demonstrate that a low incidence of BSI can be maintained over time in a tertiary care NICU. Subjects 6,790 infants admitted to a large, tertiary care NICU between 2005 and 2013. Design Retrospective intervention study. Methods A staged, multifaceted infection prevention plan was implemented beginning in October 2007 under nursing leadership. The incidence of BSI was determined annually for 2005-2013. Results Baseline BSI incidence for infants admitted to the NICU was 5.15 and 6.08 episodes per 1,000 infant-days in 2005 and 2006, respectively. After protocol implementation, the incidence of BSI decreased to 2.14/1,000 infant-days and 2.44/1,000 infant-days in 2008 and 2009, respectively. Yearly incidence remained low over the next 4 years and decreased even further to 0.20-0.45 infections/1,000 infant days. This represents a 92% decrease in BSI over a period of >5 years. Conclusions Implementation of a nursing-led comprehensive infection control initiative can effectively produce and maintain a reduction in the incidence of BSI in infants at a large tertiary care NICU. What this study adds Long term reductions in neonatal BSI are possible with implementation of a multidisciplinary team approach and strong nursing leadership.

show abstract

Section: Discussionmentioning

confidence: 99%

Sustained Reduction in Bloodstream Infections in Infants at a Large Tertiary Care Neonatal Intensive Care Unit

Neill

Haithcock

Smith

et al. 2016

Advances in Neonatal Care

View full text Add to dashboard Cite

show abstract

“…(5,7,16,17) At the NICU where the study was developed, figures for late sepsis were less expressive.…”

Section: Discussionmentioning

confidence: 99%

“…(20) The occurrence of late neonatal sepsis and its relation with the NICU environment and the invasive procedures the infants are submitted to have been widely discussed in studies undertaken in the large urban centers of Brazil and internationally. (5,7,8,17,19,21) This concern targets improvements in the quality of care for low-weight infants, reducing the sequelae of clinical problems provoked by intense infection processes and death rates.…”

Section: Discussionmentioning

confidence: 99%

“…(4) In that sense, the access to the VLBW infants' vascular network through central catheters and mechanic pulmonary ventilation, necessary for the preterm infants' life support, have been considered the main factors responsible for the occurrence of healthcare associated infections (HAI), with high rates at the NICU. (1,(5)(6)(7)(8) Neonatal sepsis is defined as a systemic response to infection, characterized by a clinical syndrome with different manifestations. (9,10) It can be classified as early (probably of maternal origin with symptoms in the first 48 hours of life) and late (probably of hospital origin).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A correlação entre procedimentos assistenciais invasivos e a ocorrência de sepse neonatal

et al. 2016

View full text Add to dashboard Cite

Objective: To correlative the invasive care procedures applied to very-low-birth-weight infants with the occurrence of neonatal sepsis. Methods: Retrospective, longitudinal cohort study undertaken through the investigation of secondary data between 2008 and 2012. The infants' characteristics were analyzed by means of the Mann-Whitney test (means) and the chi-square test to compare frequencies. All variables with significance of p<0.20 in the bivariate analysis were included in a logistic regression model. Results: The data demonstrated fourteen infants with an episode of late sepsis. The mean gestational age was 30 weeks. Female gender and cesarean birth were the most frequent. The birth weight and the use of an arterial umbilical catheter explained the occurrence of sepsis, offering an 8.5 times higher risk for the outcome. Conclusion: Vascular accesses need start insertion and handling techniques to improve the health indicators. ResumoObjetivo: Correlacionar os procedimentos assistenciais invasivos realizados nos recém-nascidos de muito baixo peso com a ocorrência de sepse neonatal. Métodos: Estudo de coorte retrospectivo, longitudinal, por meio de pesquisa de dados secundários, durante os anos de 2008-2012. As características dos recém-nascidos foram analisadas pelo teste de Mann-Whitney (médias) e o teste do qui quadrado para comparação de frequências. Todas as variáveis com significância de p<0,20 na análise bivariada compuseram um modelo de regressão logística. Resultados: Os dados demonstraram quatorze recém-nascidos com episódio de sepse tardia. A idade gestacional média foi de trinta semanas. Gênero feminino e parto cesáreo foram os mais frequentes. O peso de nascimento e o uso do cateter umbilical arterial explicaram a ocorrência de sepse, tendo este oferecido 8,5 vezes maior risco para o desfecho. Conclusão: Acessos vasculares necessitam rigor nas técnicas de inserção e manuseio para a melhoria dos indicadores de saúde.

show abstract

“…5,21,22 Data from seven Brazilian NICUs showed that the incidence of bloodstream infection associated with vascular catheter varies by birth weight: 34.9/1,000 vascular catheter (VC) days in premature infants weighing < 1,000 g, 20.4/1,000 VC days in premature infants weighing between 1,001-1,500 g, 17.3/1,000 VC days in those weighing between 1,501-2,500 g and, 18.1/1,000 VC days in infants weighing > 2,500 g. 23 These rates are much higher than those found in the National Healthcare Safety Network (NHSN), which shows rates of 4.4/1,000 VC days in those weighing < 1,000 g, 4.8/1,000 VC days between 1,001-1,500 g, 4.2/1,000 VC days between 1,501-2,500 g. and 3.1/1,000 VC days in those weighing > 2,500 g, and reinforce the importance of catheter-associated infection in this environment and the need for preventive measures against this condition of concern. 5, 24,25 In the questionnaire on vascular catheters, it was observed that only two-thirds of the centers have a PICC insertion and maintenance team, with this representing an aspect to be improved, which can be crucial as a LOS prevention strategy. The other catheter care procedures were similar between centers.…”

Section: Discussionmentioning

confidence: 99%

Practices related to late-onset sepsis in very low-birth weight preterm infants

Bentlin¹,

Rugolo²,

Ferrari³

2015

Jornal de Pediatria

View full text Add to dashboard Cite

show abstract

Risk factors and lethality of laboratory-confirmed bloodstream infection caused by non-skin contaminant pathogens in neonates

Abstract: Surgical procedures and CVC usage were significant risk factors for LCBI. Therefore, prevention practices for safe surgery and CVC insertion and manipulation are essential to reduce these infections, in addition to training and continuing education to surgical and assistance teams.

Cited by 26 publications

References 29 publications

Sustained Reduction in Bloodstream Infections in Infants at a Large Tertiary Care Neonatal Intensive Care Unit

Sustained Reduction in Bloodstream Infections in Infants at a Large Tertiary Care Neonatal Intensive Care Unit

A correlação entre procedimentos assistenciais invasivos e a ocorrência de sepse neonatal

Practices related to late-onset sepsis in very low-birth weight preterm infants

Contact Info

Product

Resources

About