Nosocomial infection in a neonatal intensive care unit: a prospective study in Taiwan.
BACKGROUND
We performed a prospective analysis to determine the prevalence of nosocomial infection and associated risk factors in our neonatal intensive care unit (NICU).


METHODS
Data were collected prospectively on underlying diagnoses, therapeutic interventions/treatments, infections, and outcomes at 9 am every day from November 2004 through October 2005. Prevalence of nosocomial infection and infection site definitions were according to the National Nosocomial Infections Surveillance system of the Centers for Disease Control and Prevention.


RESULTS
Among 528 infants enrolled, 60 (11.4%) had 97 nosocomial infections. The survival rate was 92%. The prevalence of nosocomial infections was 17.5%: bloodstream infection, 4.7%, clinical sepsis, 6.3%, pneumonia, 5.1%, urinary tract infections (UTIs), 0.7%, surgical site infection, 0.7%. Intervention-associated infection rate: central intravascular catheter-associated bloodstream infection, 13.7%, TPN-associated bloodstream infection, 15.8%, ventilator-associated pneumonia, 18.6%, surgical site infection 13.7%, urinary catheter-associated UTI, 17.3%. Cut-off values of onset of central intravascular catheter-associated bloodstream infection and ventilator-associated pneumonia were 6 days and 10 days after intervention, respectively. Patients with a birth weight <1000 g (relative risk, 11.8, 95% confidence interval, 7.66-18.18; P < .001) were at the greatest risk for nosocomial infection.


CONCLUSIONS
This study revealed the high prevalence of nosocomial infections in NICU patients, and the urgent need for a national surveillance and more effective prevention interventions.
Su
Bai-Horng
BH
Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan. bais@ms49.hinet.net
Hsieh
Hsin-Yang
HY
Chiu
Hsiao-Yu
HY
Lin
Hsiao-Chuan
HC
Lin
Hung-Chih
HC
D001724:Birth Weight; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000706:statistics & numerical data; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006700:Home Childbirth / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D011247:Pregnancy; D047928:Premature Birth; D015995:Prevalence; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects / Q000706:statistics & numerical data; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology