Effect of neonatal intensive care unit environment on the incidence of hospital-acquired infection in neonates.
The influence of the inanimate hospital environment and hospital design on nosocomial infection is a topic for discussion. This study evaluated the impact of the neonatal intensive care unit (NICU) environment on the risk of hospital-acquired infection (HAI). HAI surveillance was performed during a four-year period when the NICU was moved initially from an old facility to temporary accommodation and then eventually to a new and better-designed facility. The rate of HAI rose significantly from 12.8 to 18.6% (P<0.01) after moving to the temporary unit, which had a lower sink:cot ratio and a higher monthly admission rate. In contrast, the rates of catheter-associated staphylococcal bacteraemia decreased significantly after moving to the new NICU (P<0.0001). Since peripherally inserted central catheters (PICCs) were introduced concomitantly with the move to the new unit, however, the catheter type may have contributed towards this reduction in CVC-related staphylococcal bacteraemias. Moving to a temporary NICU with poor handwashing facilities and higher admission activity resulted in higher rates of HAI.
Von Dolinger de Brito
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D
Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, CEP 38400-902, Uberlândia, MG, Brazil. denisebrito@terra.com.br
de Almeida Silva
H
H
Jose Oliveira
E
E
Arantes
A
A
Abdallah
V O S
VO
Tannus Jorge
M
M
Gontijo Filho
P P
PP
D001938:Brazil / Q000453:epidemiology; D002405:Catheterization, Central Venous / Q000009:adverse effects; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D004777:Environment; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000209:etiology