Skip to main content
×
Home
    • Aa
    • Aa

Healthcare-Associated Infections Among Neonates in Brazil

  • Carmem Lúcia Pessoa-Silva (a1), Rosana Richtmann (a2), Roseli Calil (a3), Rosana Maria Rangel Santos (a1), Maria Luiza M. Costa (a2), Ana Cristina Cisne Frota (a1) and Sergio Barsanti Wey (a4)...
Abstract
AbstractObjective:

To describe the epidemiology of healthcare-associated infections (HAIs) among neonates.

Design:

Prospective surveillance of HAIs was conducted during 2 years. Infections beginning within 48 hours of birth were defined as HAIs of maternal origin. Death occurring during an active episode of HAI was considered related to HAI.

Setting:

Seven neonatal units located in three Brazilian cities.

Patients:

All admitted neonates were included and observed until discharge.

Results:

Twenty-two percent of 4,878 neonates had at least one HAI. The overall incidence density was 24.9 per 1,000 patient-days, and 28.1% of all HAIs were maternally acquired. HAI rates ranged from 12.3% in the group with a birth weight (BW) of more than 2,500 g to 51.9% in the group with a BW of 1,000 g or less. The main HAIs were bloodstream infection (BSI) and pneumonia. Coagulase-negative staphylococci, Enterobacter species, Staphylococcus aureus, and Klebsiella pneumoniae were the main pathogens. Forty percent of all deaths were related to HAI. Central venous catheter (CVC)-associated BSIs per 1,000 CVC-days ranged from 17.3 (BW, 1,501 to 2,500 g; device utilization [DU], 0.11) to 34.9 (BW, ≤ 1,000 g; DU, 34.92). Ventilator-associated pneumonia per 1,000 ventilator-days ranged from 7.0 (BW, ≤ 1,000 g; DU, 0.34) to 9.2 (BW, 1,001 to 1,500 g; DU, 0.14).

Conclusions:

The high proportion of HAIs of maternal origin highlights perinatal care issues in Brazil and the need to improve the diagnosis of neonatal HAIs. The very low BW group and device-associated infections should be priorities for prevention strategies in this population.

Copyright
Corresponding author
Service Prévention et Controle de l'Infection – UPCI, Hôpitaux Universitaires de Genève, 24, rue Micheli du Crest - CH-1211, Geneva 14, Switzerland
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1. LG Donowitz . Nosocomial infection in neonatal intensive care units. Am J Infect Control 1989;17:250257.

2. EL Ford-Jones , CM Mindorff , JM Langley , et al.Epidemiologic study of 4,684 hospital-acquired infections in pediatric patients. Pediatr Infect Dis J 1989;8:668675.

3. F Daschner . Analysis of bacterial infections in a neonatal intensive care unit. J Hosp Infect 1983;4:9091.

4. JA Hoogkamp-Korstanje , B Cats , RC Senders , van I Ertbruggen . Analysis of bacterial infections in a neonatal intensive care unit. J Hosp Infect 1982;3:275284.

6. AH Sohn , DO Garrett , RL Sinkowitz-Cochran , et al.Prevalence of nosocomial infections in neonatal intensive care unit patients: results from the first national point-prevalence survey. J Pediatr 2001;139:821827.

8. JS Garner , WR Jarvis , TG Emori , TC Horan , JM Hughes . CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128140.

10. TC Horan , TG Emori . Definitions of key terms used in the NNIS System. Am J Infect Control 1997;25:112116.

11. CL Pessoa-Silva , B Meurer Moreira , V Camara Almeida , et al.Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit: risk factors for infection and colonization. J Hosp Infect 2003;53:198206.

12. VG Hemming , JC Overall Jr, MR Britt . Nosocomial infections in a newborn intensive-care unit: results of forty-one months of surveillance. N Engl J Med 1976;294:13101316.

13. A Josephson , L Karanfil , H Alonso , A Watson , J Blight . Risk-specific nosocomial infection rates. Am J Med 1991;91(suppl 3B):131S137S.

15. ML Moro , A De Toni , I Stolti , MP Carrieri , M Braga , C Zunin . Risk factors for nosocomial sepsis in newborn intensive and intermediate care units. Eur J Pediatr 1996;155:315322.

16. JY Kawagoe , CA Segre , CR Pereira , MF Cardoso , CV Silva , JT Fukushima . Risk factors for nosocomial infections in critically ill newborns: a 5-year prospective cohort study. Am J Infect Control 2001;29:109114.

17. JJ Ho . Late onset infection in very low birth weight infants in Malaysian level 3 neonatal nurseries. Pediatr Infect Dis J 2001;20:557560.

18. RA Ehrenkranz , N Younes , JA Lemons , et al.Longitudinal growth of hospitalized very low birth weight infants. Pediatrics 1999;104:280289.

19. CL Pessoa-Silva , CH Miyasaki , MF de Almeida , BI Kopelman , RL Raggio , SB Wey . Neonatal late-onset bloodstream infection: attributable mortality, excess of length of stay and risk factors. Eur J Epidemiol 2001;17:715720.

21.National Nosocomial Infections Surveillance (NNIS) System. National Nosocomial Infections Surveillance (NNIS) System report: data summary from January 1992-June 2001, issued August 2001. Am J Infect Control 2001;29:404421.

22. ML Pearson . Guideline for prevention of intravascular device-related infections. Infect Control Hosp Epidemiol 1996;17:438473.

25. S Hugonnet , H Sax , P Eggimann , J-C Chevrolet , D Pittet . Nosocomial bloodstream infection and clinical sepsis. Emerg Infect Dis 2004;10:7681.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score