title: [Analysis of risk factors for nosocomial infections in the Neonatal Intensive Care Unit of the Pomeranian Medical University in Szczecin in the years 2005-2008].
abstract: The aim of the study was to assess the significance of some perinatal risk factors and neonatal complications in occurrence of nosocomial infections in the population of NICU patients.
  
  
  METHODS
  Analysis of risk factors was performed in all patients treated in the years 2005-2008 in NICU Department of the Pomeranian Medical University in Szczecin, Poland. Five hundred and seventeen neonates divided into groups with and without occurrence of nosocomial infection were included into the study.
  
  
  RESULTS
  Seventy-nine (15.28%) neonates developed nosocomial infection. Among them pneumonia (56.96%) and sepsis (21.5%) were the most common. The proportion of Gram-positive and Gram negative organisms were 44.3% and 50.6% respectively. The main risk factor for nosocomial infection was colonization (sensitivity--100% and specificity--94.75%). Univariate analysis showed that premature rupture of fetal membrane, GA<32 hbd, birthweight <2000 g, respiratory insufficiency intracranial hemorrhages and oral feeding intolerance were associated with the development of nosocomial infection. Multivariate stepwise logistic regression analysis showed that mechanical ventilation - OR 9.42 [4.45-19.96] p<0.0001, intracranial hemorrhages--OR 4.12 [2.21-7.67] p<0.0001, necessity of Infant-Flow method--OR 3.32 [1.82-6.06] p<0.0001or n-CPAP method--OR 1.92 [1.07-3.44] p<0.05, necrotizing enterocolitis--OR 2.38 [1.17-4.87] p<0.05 and intrauterine hypotrophy--OR 1.8 [1.07-3.76] p<0.05 were sets of predicted factors for the development of nosocomial infection. We conclude that colonization of NICU patients with hospital pathogens is the most important risk factor of nosocomial infection incidence. Besides colonization, significant additional risk factors for nosocomial infection were mechanical ventilation, intraventricular hemorrhages, low birth weight and low gestational age.
authors.affiliation: Klinika Neonatologii PAM w Szczecinie.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Elster
authors.forename: Maria
authors.initials: M
authors.lastname: Beata Czeszyńska
authors.forename: Diana
authors.initials: D
authors.lastname: Sochaczewska
authors.forename: Halina
authors.initials: H
authors.lastname: Konefał
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Baryła-Pankiewicz
mesh_terms: D016470:Bacteremia / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods; D007363:Intensive Care Units, Neonatal; D008297:Male; D015999:Multivariate Analysis; D011014:Pneumonia / Q000382:microbiology; D011044:Poland / Q000453:epidemiology; D012307:Risk Factors