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Risk Factors for Nosocomial Infection in a Neonatal Intensive Care Unit

  • Renato C. Couto (a1), Tania M. G. Pedrosa (a1), Cristina de Paula Tofani (a2) and Enio R. P. Pedroso (a1)
Abstract
Objective.

To determine risk factors for nosocomial infection in a neonatal intensive care unit (NICU).

Design.

A prospective, open cohort study.

Setting.

A 22-bed NICU.

Patients.

Neonates admitted to a single NICU during 1994-1998 were included in the study. Outcome variables included central venous catheter (CVC)–associated primary bloodstream infection (BSI), non–CVC-associated primary BSI, pneumonia, and overall nosocomial infection. Independent variables included birth weight, use of mechanical ventilation (MV), duration of MV, use of a CVC, duration of CVC use, duration of NICU stay, gestational age, congenital malformation, maximum (ie, worst) base excess, and maximum and minimum fraction of inspired oxygen (FIO2) for maintaining appropriate blood saturation levels during the first 12 hours after NICU admission.

Results.

A total of 1051 neonates were admitted to the NICU. Overall, 358 NIs were diagnosed. Non–CVC-associated primary BSI was the most frequent nosocomial infection (in 195 neonates [54.5%]), followed by pneumonia (46 [12.8%]), and CVC-associated primary BSI (35 [9.8%]). The mortality rate was 16%. In the final logistic regression model, the following 5 risk factors were found to be predictive of nosocomial infection development: use of MV, longer duration of MV, longer duration of CVC use, longer duration of NICU stay, and low maximum appropriate FIO2.

Conclusion.

Invasive device use and duration of use continue to greatly influence the development of nosocomial infection in NICUs. In our cohort, birth weight showed no influence on the development of nosocomial infection. Low maximum FIO2 influenced the occurrence of overall nosocomial infection.

Copyright
Corresponding author
348 Alameda dos Ipês street, Bosque da Ribeira, Nova Lima, Minas Gerais, Brazil 34000000 (renatoccouto@globo.com)
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2. 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.

, . . ; :–.4. S Nambiar N Singh Change in epidemiology of health care–associated infections in the neonatal intensive care unit Pediatr Infect Dis J 2002 21 839842

5. WR Jarvis . Controlling healthcare-associated infections: the role of infection control and antimicrobial use practices. Semin Pediatr Infect Dis 2004; 15:3040.

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

. . ; :–.8.The International Neonatal NetworkThe CRIB (Clinical Risk Index for Babies) score: a tool for assessing initial neonatal risk and comparing performance of neonatal intensive care units Lancet 1993 342 193198

, , , . . ;():–.9. RP Gaynes WJ Martone DH Culver et alComparison of rates of nosocomial infections in neonatal intensive care units in the United States Am J Med 1991 91 Suppl 3B192S196S

, , , . . ; :–.12. CM Beck-Sague P Azimi SN Fonseca et alBloodstream infections in neonatal intensive care unit patients: results of a multicenter study Pediatr Infect Dis J 1994 13 11101116

, , , . . ; :–.13. BJ Stoll N Hansen AA Fanaroff et alLate-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network Pediatrics 2002 110 285289

, , , . . ; :–.14. BJ Stoll T Gordon SB Korones et alLate-onset sepsis in very low birth weight neonates: a report from the National Institute of Child Health and Human Development Neonatal Research Network J Pediatr 1996 129 6371

15. IR Makhoul , P Sujov , T Smolkin , A Lusky , B Reichman . Epidemiological, clinical, and microbiological characteristics of late-onset sepsis among very low birth weight infants in Israel: a national survey. Pediatrics 2002; 109:3439.

, , , , . . ; :–.16. A Apisarnthanarak G Holzmann-Pazgal A Hamvas MA Olsen BJ Fraser Ventilator-associated pneumonia in extremely preterm neonates in a neonatal intensive care unit: characteristics, risk factors, and outcomes Pediatrics 2003 112 12831289

. ; :–.17.National Nosocomial Infections Surveillance (NNIS) System Report: data summary from January 1992 through June 2004, issued October 2004 Am J Infect Control 2004 32 470485

, , . . ; :–.18. DA Goldmann WA Durbin Jr J Freeman Nosocomial infections in a neonatal intensive care unit J Infect Dis 1981 144 449459

, , , , . . ; :–.20. PW Fowlie CR Gould GJ Parry G Phillips WO Tarnow-Mordi CRIB (clinical risk index for babies) in relation to nosocomial bacteraemia in very low birthweight or preterm infants Arch Dis Child Fetal Neonatal Ed 1996 75 F49F52

, . . ; :–.22. BJ Stoll N Hansen Infections in VLBW infants: studies from the NICHD Neonatal Research Network Semin Perinatol 2003 27 293301

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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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