Nosocomial infections in a neonatal intensive care unit during 16 years: 1997-2012

Abstract

Introduction: Surveillance of nosocomial infections (NIs) is an essential part of quality patient care; however, there are few reports of National Healthcare Safety Network (NHSN) surveillance in neonatal intensive care units (NICUs) and none in developing countries. The purpose of this study was to report the incidence of NIs, causative organisms, and antimicrobial susceptibility patterns in a large cohort of neonates admitted to the NICU during a 16-year period. Methods: The patients were followed 5 times per week from birth to discharge or death, and epidemiological surveillance was conducted according to the NHSN. Results: From January 1997 to December 2012, 4,615 neonates, representing 62,412 patient-days, were admitted to the NICU. The deviceassociated infection rates were as follows: 17.3 primary bloodstream infections per 1,000 central line-days and 3.2 pneumonia infections per 1,000 ventilator-days. A total of 1,182 microorganisms were isolated from sterile body site cultures in 902 neonates. Coagulase-negative staphylococci (CoNS) (34.3%) and Staphylococcus aureus (15.6%) were the most common etiologic agents isolated from cultures. The incidences of oxacillin-resistant CoNS and Staphylococcus aureus were 86.4% and 28.3%, respectively. Conclusions:The most important NI remains bloodstream infection with staphylococci as the predominant pathogens, observed at much higher rates than those reported in the literature. Multiresistant microorganisms, especially oxacillin-resistant staphylococci and gram-negative bacilli resistant to cephalosporin were frequently found. Furthermore, by promoting strict hygiene measures and meticulous care of the infected infants, the process itself of evaluating the causative organisms was valuable.

A molecular epidemiological study of methicillin-resistantStaphylococcienvironmental contamination in railway stations and coach stations in Guangzhou of China

“…CNS is a kind of opportunistic pathogenic bacteria, and it has recently been noticed in the public health field since several studies have reported its higher prevalence within neonates (Urzedo et al . ) and higher methicillin‐resistance rate among outpatients (Lerbech et al . ).…”

“…Since Methicillin-resistant S. aureus (MRSA) first found in 1961, it has caused a series of public health problems (Rollnik 2014;Yaw et al 2014). CNS is a kind of opportunistic pathogenic bacteria, and it has recently been noticed in the public health field since several studies have reported its higher prevalence within neonates (Urzedo et al 2014) and higher methicillin-resistance rate among outpatients (Lerbech et al 2014).…”

Neonatal sepsis in a rapidly growing, tertiary neonatal intensive care unit: Trends over 18 years

“…3,4 The patterns of the bacterial pathogens responsible for neonatal sepsis, however, have changed with developments in intensive care units. [5][6][7] The preterm birth rate continues to increase in most developed countries. In the USA, the rate of preterm births increased by approximately 30% from 1981 to 2006; 8 in Europe, reported preterm rates are generally 5-9%.…”

Improving nursing knowledge and care for neonates with respiratory distress in Jordan

“…; Urzedo et al. ), ultimately prolonging the stay in NICUs and thus increasing medical costs. Lissauer et al.…”

“…More specifically, a meta-study by Imbulana et al (2018) found that between 20 and 100% of premature infants sustained a nasal injury attributable to binasal prong CPAP. Furthermore, the use of mechanical ventilation was found to increase infections among neonates (Tan et al 2014;Urzedo et al 2014), ultimately prolonging the stay in NICUs and thus increasing medical costs. Lissauer et al (2017) emphasized the need for specialized training provided for nurses in low-and middle-income countries about assisted ventilation such as the use of NCPAP.…”