Surveillance of healthcare-associated infections in a neonatal intensive care unit in Italy during 2006–2010

Abstract

BackgroundHealthcare-associated infections (HAIs) are a frequent complication associated with hospitalization of infants in neonatal intensive care units (NICUs). The aim of this study was to evaluate and describe the results of surveillance of HAIs in a III level NICU in Naples, Italy during 2006–2010.MethodsThe surveillance covered 1,699 neonates of all birth weight (BW) classes with > 2 days NICU stay. Infections were defined using standard Centers for Disease Control and Prevention definitions adapted to neonatal pathology and were considered to be healthcare-associated if they developed > 2 days after NICU admission.ResultsOne hundred-fifty-three HAIs were diagnosed with a frequency of 9% and an incidence density of 3.5 per 1000 days of hospital stay. HAIs developed in all BW classes, but patients weighing ≤ 1000 g at birth were more affected with a decreasing trend from the lowest to the highest BW classes. Sepsis proved to be the most frequent infection (44.4%), followed by urinary tract infection (UTI) (28.8%), pneumonia (25.5%) and meningitis (1.3%). Device associated infections (i.e. central line-associated bloodstream infections (BSIs), umbilical catheter-associated BSI and ventilator associated pneumonias (VAPs) represented 64.1% of all HAIs. Most frequent pathogens responsible for all types of infections were: P. aeruginosa (17%), C. parapsilosis (16.3%), E. coli (13.1%), C. albicans (10.5%), non- extended spectrum beta-lactamase (ESBL) K. pneumoniae (7.8%), and coagulase-negative Staphylococci (5.2%). No microbiological diagnosis was achieved for 6.5% of infections.ConclusionsHAIs developed in all BW classes but low BW neonates were at major risk to acquire HAIs in our NICU. Use of central line-, umbilical-catheter and mechanical ventilation was associated with higher risk of infection. Our findings highlight the importance of an extensive surveillance approach in the NICU setting, which includes all BW classes of neonates and monitors infections associated with the use of medical devices.

The Oral Cavity: A Reservoir that Favors Colonization and Selection of Candida parapsilosis sensu stricto Strains with High Pathogen Potential Under Conditions of Gingival-periodontal Disease

“…Currently, Candida parapsilosisis considered as a nosocomial emerging pathogen [33][34][35][36], and its growing resistance to azoles and echinocandins [37][38][39] has put it under the spotlight in the last few years. It is a complex of 3 phenotypically indistinguishable species, but, due to their genetic heterogeneity, it is possible to differentiate them only with molecular techniques [40].…”

Fatores de Risco para Sépsis Associada aos Cuidados de Saúde em Recém-nascidos de Muito Baixo Peso

“…[12][13][14][15] Muitas das infeções associadas aos CVC são causadas por Staphylococcus coagulase negativos (SCN) ou outros colonizadores da pele circundante à inserção do CVC ou das suas conexões.…”

Microcalorimetry and turbidimetry to investigate the anti-bacterial activities of five fractions from the leaves of Dracontomelon dao on P. aeruginosa

“…It is even worse that the overall rate of nosocomial P. aeruginosa infections has increased rapidly in some patient groups [10]. Moreover, P. aeruginosa was the leading pathogen (17 %) responsible for all types of infections including sepsis, urinary tract infection and pneumonia (2006)(2007)(2008)(2009)(2010) [11]. P. aeruginosa has caused serious burden to public health care and safety with the characteristic of drug resistance in recent years [12][13][14][15].…”