Nosocomial infections in a neonatal intensive care unit: incidence and risk factors.
BACKGROUND
Nosocomial infections (NIs) have become a matter of major concern in neonatal intensive care units (NICUs). The objectives of this study were to determine the incidence rate and the most frequent sites of infection in a Brazilian NICU from January 1999 to March 2000 and to study the risk factors for NIs.


METHODS
A cohort study was carried out in which 225 neonates who remained at least 24 hours in the NICU were followed-up; neonates with NIs were identified, and the presence of risk factors was studied. Results were submitted to chi(2) distribution.


RESULTS
The incidence rate and the incidence density rate were 50.7% and 62 infections per 1000 patient-days, respectively. In order of frequency, the sites of infection were: pneumonia (40.3%), primary bloodstream (16.7%), skin and soft tissue (14.9%), and meningitis (9.6%). The following risk factors were associated with NIs (P <.05): birth weight, gestational age, mechanical ventilation, total parenteral nutrition, umbilical catheter, use of antibiotics, and intubation in the delivery room.


CONCLUSIONS
Risk factors were similar to those reported by other authors. However, incidence rates of infections in our NICU were much higher, possibly because of different methodologies and the adopted criteria for the classification of NIs.
Nagata
Edison
E
Hospital Universitario de Londrina, State University, Brazil.
Brito
Angela S J
AS
Matsuo
Tiemi
T
D001938:Brazil / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D012307:Risk Factors