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Healthcare-Associated Infections Among Neonates in Brazil

Published online by Cambridge University Press:  02 January 2015

Carmem Lúcia Pessoa-Silva ,
Rosana Richtmann ,
Roseli Calil ,
Rosana Maria Rangel Santos ,
Maria Luiza M. Costa ,
Ana Cristina Cisne Frota  and
Sergio Barsanti Wey
Carmem Lúcia Pessoa-Silva*
Affiliation:
Universidade Federal do Rio de Janeiro, Rio de JaneiroBrazil
Rosana Richtmann
Affiliation:
Hospital e Maternidade Santa Joana, São PauloBrazil
Roseli Calil
Affiliation:
UNICAMP/Universidade Estadual de Campinas, São Paulo, Brazil
Rosana Maria Rangel Santos
Affiliation:
Universidade Federal do Rio de Janeiro, Rio de JaneiroBrazil
Maria Luiza M. Costa
Affiliation:
Hospital e Maternidade Santa Joana, São PauloBrazil
Ana Cristina Cisne Frota
Affiliation:
Universidade Federal do Rio de Janeiro, Rio de JaneiroBrazil
Sergio Barsanti Wey
Affiliation:
Universidade Federal de São Paulo, São Paulo, Brazil
*
Service Prévention et Controle de l'Infection – UPCI, Hôpitaux Universitaires de Genève, 24, rue Micheli du Crest - CH-1211, Geneva 14, Switzerland
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Abstract

Objective:

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.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 9 , September 2004 , pp. 772 - 777
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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References

1.Donowitz, LG. Nosocomial infection in neonatal intensive care units. Am J Infect Control 1989;17:250–257.Google Scholar
2.Ford-Jones, EL, Mindorff, CM, Langley, JM, et al.Epidemiologic study of 4,684 hospital-acquired infections in pediatric patients. Pediatr Infect Dis J 1989;8:668–675.CrossRefGoogle Scholar
3.Daschner, F. Analysis of bacterial infections in a neonatal intensive care unit. J Hosp Infect 1983;4:90–91.CrossRefGoogle Scholar
4.Hoogkamp-Korstanje, JA, Cats, B, Senders, RC, van Ertbruggen, I. Analysis of bacterial infections in a neonatal intensive care unit. J Hosp Infect 1982;3:275–284.Google Scholar
5.Raymond, J, Aujard, Y, Group, ES. Nosocomial infections in pediatric patients: a European, multicenter prospective study. Infect Control Hosp Epidemiol 2000;20:260–263.CrossRefGoogle Scholar
6.Sohn, AH, Garrett, DO, Sinkowitz-Cochran, RL, et al.Prevalence of nosocomial infections in neonatal intensive care unit patients: results from the first national point-prevalence survey. J Pediatr 2001;139:821–827.Google Scholar
7.Gaynes, RP, Horan, TC. Surveillance of nosocomial infections. In: Mayhall, G, ed. Hospital Epidemiology and Infection Control. Baltimore: Williams & Wilkins; 1999:1285–1317.Google Scholar
8.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128–140.Google Scholar
9.Gaynes, RP, Edwards, JR, Jarvis, WR, Culver, DH, Toison, JS, Martone, WJ. Nosocomial infections among neonates in high-risk nurseries in the United States. Pediatrics 1996;98(3 part 1):357–361.CrossRefGoogle ScholarPubMed
10.Horan, TC, Emori, TG. Definitions of key terms used in the NNIS System. Am J Infect Control 1997;25:112–116.Google Scholar
11.Pessoa-Silva, CL, Meurer Moreira, B, Camara Almeida, V, 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;53:198–206.CrossRefGoogle Scholar
12.Hemming, VG, Overall, JC Jr, Britt, MR. Nosocomial infections in a newborn intensive-care unit: results of forty-one months of surveillance. N Engl J Med 1976;294:1310–1316.Google Scholar
13.Josephson, A, Karanfil, L, Alonso, H, Watson, A, Blight, J. Risk-specific nosocomial infection rates. Am J Med 1991;91(suppl 3B):131S–137S.Google Scholar
14.Maguire, GC, Nordin, J, Myers, MG, Koontz, FP, Hierholzer, W, Nassif, E. Infections acquired by young infants. Am J Dis Child 1981;135:693–698.Google Scholar
15.Moro, ML, De Toni, A, Stolti, I, Carrieri, MP, Braga, M, Zunin, C. Risk factors for nosocomial sepsis in newborn intensive and intermediate care units. Eur J Pediatr 1996;155:315–322.Google Scholar
16.Kawagoe, JY, Segre, CA, Pereira, CR, Cardoso, MF, Silva, CV, Fukushima, JT. Risk factors for nosocomial infections in critically ill newborns: a 5-year prospective cohort study. Am J Infect Control 2001;29:109–114.CrossRefGoogle ScholarPubMed
17.Ho, JJ. Late onset infection in very low birth weight infants in Malaysian level 3 neonatal nurseries. Pediatr Infect Dis J 2001;20:557–560.Google Scholar
18.Ehrenkranz, RA, Younes, N, Lemons, JA, et al.Longitudinal growth of hospitalized very low birth weight infants. Pediatrics 1999;104:280–289.Google Scholar
19.Pessoa-Silva, CL, Miyasaki, CH, de Almeida, MF, Kopelman, BI, Raggio, RL, Wey, SB. Neonatal late-onset bloodstream infection: attributable mortality, excess of length of stay and risk factors. Eur J Epidemiol 2001;17:715–720.Google Scholar
20.Townsend, TR, Wenzel, RP. Nosocomial bloodstream infections in a newborn intensive care unit: a case-matched control study of morbidity, mortality and risk. Am J Epidemiol 1981;114:73–80.Google Scholar
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;29:404–421.CrossRefGoogle Scholar
22.Pearson, ML. Guideline for prevention of intravascular device-related infections. Infect Control Hosp Epidemiol 1996;17:438–473.Google Scholar
23.Centers for Disease Control and Prevention. Guidelines for prevention of nosocomial pneumonia. MMWR 1997;46(RR-1):1–79.Google Scholar
24.Stoll, BJ. The global impact of neonatal infection. Clin Perinatal 1997;24:1–21.Google Scholar
25.Hugonnet, S, Sax, H, Eggimann, P, Chevrolet, J-C, Pittet, D. Nosocomial bloodstream infection and clinical sepsis. Emerg Infect Dis 2004;10:76–81.Google Scholar