Retrospective Epidemiological Investigation on Nosocomial Neonatal Sepsis in Shaanxi Province (2008-2010)

Abstract

Objective: This study assessed the incidence, mortality, and pathogens associated with nosocomial neonatal sepsis (NNS) in Shaanxi Province to improve the prevention and control of NNS. Methods: Nine large neonatal departments in Shaanxi Province participated in this retrospective epidemiological investigation of NNS during the period of 2008-2010, using standardized protocol. The incidence, mortality, pathogens, antibiotic sensitivity, clinical characteristics, prognosis, and costs were analyzed. Results: Of 16,642 neonates admitted to neonatal departments in the 9 hospitals during 2008-2010, there were 139 cases of NNS, with incidence of 8.3% and mortality of 20.8%. The predominant pathogens were Gram-negative bacteria, accounting for 67.6% of positive cultures. Gram-positive bacteria accounted for 24.5% and fungal infection accounted for 7.9%. The most common Gram-negative species were Klebsiella pneumonia (22.3%), Escherichia coli (15.1%), and Enterobacter cloacae (8.6%). The dominant Gram-positive species identified were coagulase negative staphylococcal species (CONS) (8.6%), followed by Staphylococcus aureus 263tance, but no meropenem-or-vancomycin-resistant strains were detected. Preterm and full-term infants showed significant difference in clinical manifestations, laboratory findings, mortality, and cost. Conclusion: NNS in the hospitals of Shaanxi Province showed a decreasing trend from 2008 to 2010, but the mortality did not reduce significantly. The predominant bacteria were Gram negative, and pathogens were found to have varying antibiotic resistance. The preterm group had higher mortality and costs than the full-term infants. Therefore, effective measures should be taken to control NNS, especially in preterm infants.

Late Neonatal Bacterial Infection at the Brazzaville Teaching Hospital

“…These are: neonatal resuscitation (39.7%), previous hospitalization (36.2%) and previous antibiotic therapy (24.1%). These factors have been reported by various authors at varying frequencies [9] [12] [22].…”

“…Nejjari and Maoulainine in Morocco have a respective frequency of health acquired infection of 2.03% and 13% [19] [20]. In France, it is 5.9% [21], in Turkey 6.4% and in China the frequency is 0.8% [22] [23]. The high frequencies in these different departments are mainly due to the more important practices than in our department of invasive procedures recognized as risk factors of health acquired infection [11] [24].…”

Identifying a competency improvement strategy for infection prevention and control professionals: A rapid systematic review and cluster analysis

“…Of the 46 studies included in the analysis, 14 were carried out in the United States [12–25], 11 in China [26–36], four in each of the United Kingdom [27, 37–39] and Switzerland [6, 7, 40, 41], three in Italy [42–44], two in South Africa [45, 46] and one in each of Germany [8], Saudi Arabia [47], Finland [48], the Netherlands [49], Australia [50], Ghana [51], Pakistan [52], and Singapore [53]. There were 20 cross‐sectional studies [8, 15–17, 24, 25, 31, 32, 34–37, 39–41, 49–52, 54], 15 qualitative studies [6, 7, 13, 14, 19, 21, 23, 26, 28, 29, 38, 42, 45, 46, 48], eight before–after studies [12, 20, 22, 27, 30, 33, 47, 53], two retrospective studies [18, 44] and one prospective observational study [43] (Table 2).…”

Epidemiologic features of neonatal sepsis and its COVID-19 associated temporal patterns in Jimma Medical Center, Ethiopia: A Joinpoint regression analysis

“…Some countries endorse maternal antisepsis, such as vaginal chlorhexidine during labor and antibiotic prophylaxis during delivery, to significantly reduce the incidence trend of neonatal sepsis. whereas, regrettably, middle- and low-income countries do not use any of the prevention methods or use them inconsistently [ 53 , 54 ]. Evidence also points to a clear relationship between the incidence trend of newborn sepsis and the intensity of the COVID-19 containment measures.…”

“…For the reason of discrepancies among the results, a multi-faceted factor could be hypothesized, while strict visitation policies and health-seeking behaviors take the principal role [ 53 ]. Because of the frustration from COVID-19 and sepsis overlapping symptoms, neonatal caregivers’ health-seeking behaviors appeared to be at the earliest possible time during COVID-19, contributing to a variable degree of reduction in the features of neonatal sepsis [ 62 ].…”