Hospital-acquired infection surveillance in a neonatal intensive care unit.
BACKGROUND
Hospital-acquired infections (HAIs) represent an important cause of morbidity and mortality in neonatal intensive care units (NICUs).


METHODS
All neonates admitted for > 48 hours between January 2003 and December 2006 in the NICU of the teaching hospital Umberto I of Rome, Italy were considered.


RESULTS
Of the 575 neonates evaluated, 76 (13.2%) developed a total of 100 HAIs, including 36 bloodstream infections (BSIs), 33 pneumonias, 19 urinary tract infections, 8 conjunctivitis, and 4 onphalitis. There were 7.8 HAIs/1000 patient-days and 12.5 BSIs/1000 days of umbilical catheterization. Logistic analysis identified an association with mechanical ventilation (odds ratio [OR] = 3.05; 95% confidence interval [CI] = 1.75 to 5.31; P < .01) and birth weight <or= 1500 g (OR = 2.34; 95% CI = 1.36 to 4.03; P < .01). Thirty-five neonates (6.1%) died. Klebsiella pneumoniae (37.7%) and coagulase-negative staphylococci (28.6%) were the most frequently isolated microorganisms. Only 3 Candida spp determined BSIs (8.3%). BSI mortality was higher in infections with gram-negative pathogens (36.4%) than in infections with gram-positive pathogens (4.5%).


CONCLUSIONS
Although we found a low infection and mortality rate, attention should be directed toward antibiotic-resistant gram-negative pathogens.
Orsi
Giovanni Battista
GB
Department of Public Health Sciences, La Sapienza University, Rome, Italy. giovanni.orsi@uniroma1.it
d'Ettorre
Gabriella
G
Panero
Alessandra
A
Chiarini
Fernanda
F
Vullo
Vincenzo
V
Venditti
Mario
M
D001424:Bacterial Infections / Q000453:epidemiology* / Q000401:mortality; D002175:Candida / Q000302:isolation & purification; D003428:Cross Infection / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D008297:Male; D009181:Mycoses / Q000453:epidemiology* / Q000401:mortality; D015995:Prevalence; D012384:Rome / Q000453:epidemiology; D013210:Staphylococcus / Q000302:isolation & purification