A prospective incidence study of nosocomial infections in a neonatal care unit.
BACKGROUND
Health care improvements and technical advances for diagnostic and therapeutic management in the neonatal care unit (NCU) have made possible the increasing survival of neonates with severe pathologic conditions. However, nosocomial infections (NI) still represent an important cause of morbidity and mortality in this population.


OBJECTIVE
To describe the epidemiologic profile of NI in the NCU.


METHODS
A prospective surveillance study was performed in the NCU at a university hospital in Barcelona during 6 months. Two hundred sixty-eight neonates were admitted during the study period. Centers for Disease Control and Prevention criteria were used as standard definitions for NI. Data including risk factors associated with NI were recorded.


RESULTS
Sixty-five neonates had a total of 88 NI. The incidence rate of NI was 1.6 per 100 patient-days. The accumulative rate of NI was 32.7 per 100 admissions. Bacteremia (28.4%), conjunctivitis (19.5%), respiratory infection (10.2%), and urinary tract infection (7.9%) were the most common episodes observed. Gram-positive bacteria were the most commonly isolated germs (76.4%), with coagulase-negative Staphylococcus (72.5%) being the main pathogen. Intrinsic risk factors related to NI were low birth weight (<1000 g) and urinary catheter and peripheral venous catheter (P<.01).


CONCLUSIONS
NI represent an important and frequent problem in neonates. Knowledge of the incidence of NI allows the targeting and implementation of preventive strategies for reducing morbidity and mortality related to NI in an NCU.
Urrea
Mireya
M
Quality Service-Infection Hospital Program, Hospital Sant Joan de Déu de Barcelona, Barcelona, Spain.
Iriondo
Martin
M
Thio
Marta
M
Krauel
Xavier
X
Serra
Marisa
M
LaTorre
Cristina
C
Jiménez
Rafael
R
D001424:Bacterial Infections / Q000453:epidemiology*; D002404:Catheterization / Q000009:adverse effects; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology