Prevalence of nosocomial infections in neonatal intensive care unit patients: Results from the first national point-prevalence survey.
OBJECTIVE
Patients admitted to neonatal intensive care units (NICUs) are at high risk of nosocomial infection. We conducted a national multicenter assessment of nosocomial infections in NICUs to determine the prevalence of infections, describe associated risk factors, and help focus prevention efforts.


METHODS
We conducted a point prevalence survey of nosocomial infections in 29 Pediatric Prevention Network NICUs. Patients present on the survey date were included. Data were collected on underlying diagnoses, therapeutic interventions/treatments, infections, and outcomes.


RESULTS
Of the 827 patients surveyed, 94 (11.4%) had 116 NICU-acquired infections: bloodstream (52.6%), lower respiratory tract (12.9%), ear-nose-throat (8.6%), or urinary tract infections (8.6%). Infants with infections were of significantly lower birth weight (median 1006 g [range 441 to 4460 g] vs 1589 g [range 326 to 5480 g]; P <.001) and had longer median durations of stay than those without infections (88 days [range 8 to 279 days] vs 32 days [range 1 to 483 days]; P <.001). Most common pathogens were coagulase-negative staphylococci and enterococci. Patients with central intravascular catheters (relative risk = 3.81, CI 2.32-6.25; P <.001) or receiving total parenteral nutrition (relative risk = 5.72, CI 3.45-9.49; P <.001) were at greater risk of bloodstream infection.


CONCLUSIONS
This study documents the high prevalence of nosocomial infections in patients in NICUs and the urgent need for more effective prevention interventions.
Sohn
A H
AH
Division of Healthcare Quality Promotion (formerly Hospital Infections Program), National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Garrett
D O
DO
Sinkowitz-Cochran
R L
RL
Grohskopf
L A
LA
Levine
G L
GL
Stover
B H
BH
Siegel
J D
JD
Jarvis
W R
WR
D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000706:statistics & numerical data; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D016983:Enterococcus / Q000302:isolation & purification; D005260:Female; D006306:Health Surveys; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D017053:Infection Control; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D010038:Otorhinolaryngologic Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D010289:Parenteral Nutrition, Total / Q000009:adverse effects / Q000706:statistics & numerical data; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D018805:Sepsis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D013210:Staphylococcus / Q000302:isolation & purification; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology