title: Risk factors for nosocomial infection in the neonatal intensive care unit by the Japanese Nosocomial Infection Surveillance (JANIS).
abstract: We evaluated the infection risks in the neonatal intensive care unit (NICU) using data of NICU infection surveillance data. The subjects were 871 NICU babies, consisting of 465 boys and 406 girls, who were cared for between June 2002 and January 2003 in 7 medical institutions that employed NICU infection surveillance. Infections were defined according to the National Nosocomial Infection Surveillance (NNIS) System. Of the 58 babies with nosocomial infections, 15 had methicillin-resistant Staphylococcus aureus (MRSA) infection. Multiple logistic regression analysis demonstrated that the odds ratio for nosocomial infections was significantly related to gender, birth weight and the insertion of a central venous catheter (CVC). When the birth weight group of more than 1, 500 g was regarded as the reference, the odds ratio was 2.35 in the birth weight group of 1,000-1,499 g and 8.82 in the birth weight group of less than 1,000g. The odds ratio of the CVC (+) for nosocomial infection was 2.27. However, other devices including artificial ventilation, umbilical artery catheter, umbilical venous catheter, and urinary catheter were not significant risk factors. The incidence of MRSA infection rapidly increased from 0.3% in the birth weight group of more than 1,500 g to 2.1% in the birth weight group of 1,000-1,499 g, and to 11.1% in the birth weight group of less than 1,000g. When the birth weight group of more than 1,500 g was regarded as the reference, multiple logistic regression analysis demonstrated that the odds ratio was 7.25 in the birth weight group of 1,000-1,499 g and 42.88 in the birth weight group of less than 1,000g. These odds ratios were significantly higher than that in the reference group. However, the application of devices did not cause any significant differences in the odds ratio for MRSA infection.
authors.affiliation: Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. babazono@hcam.med.kyushu-u.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Babazono
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kitajima
authors.forename: Shigeru
authors.initials: S
authors.lastname: Nishimaki
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Nakamura
authors.forename: Seigo
authors.initials: S
authors.lastname: Shiga
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hayakawa
authors.forename: Tahei
authors.initials: T
authors.lastname: Tanaka
authors.forename: Kazuo
authors.initials: K
authors.lastname: Sato
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakayama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ibara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Une
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Doi