title: A 4-year surveillance of device-associated nosocomial infections in a neonatal intensive care unit.
abstract: BACKGROUND
  The aim of this study was to determine the rate of health care-associated infection (HC-AI) and device-associated health care-associated infections (DA-HAIs), and distribution of causative microorganisms and etiologic factors responsible for these infections in a neonatal intensive care unit (NICU) of a state hospital in southeastern Turkey.
  
  
  METHODS
  A laboratory-based, active, prospective nosocomial infection surveillance study was performed in NICUs from January 2008 to December 2011. The rates of HC-AIs were determined on a daily basis. The findings were evaluated by applying the definitions of the Centers for Disease Control and Prevention National Healthcare Safety Network.
  
  
  RESULTS
  In a 4-year period, 580 HC-AIs, 81 of which were DA-HAIs, were detected among 6932 patients. The rate of hospital acquired infection was 8.3% and 7.69/1000 patient days. Ventilator-associated pneumonia (VAP) was the second most frequent (13.1%) HC-AI and the most frequent was DA-HAI. The VAP rate was 6.4 per 1000 ventilator days. Mechanical ventilation was the most frequently used invasive device. Median time to diagnosis of VAP was 32.11 ± 29.3 days from the time of admission. Acinetobacter baumannii (48%) and Pseudomonas aeruginosa (32%) were the most frequent microorganisms. Colistin was the most effective antibiotic by in vitro test. The antibiotic resistance ratios of A. baumannii were ≥54% for carbapenems, aminoglycosides, and cefoperazone-sulbactam; ≥88% for quinolones; and ≥92% for ceftazidime, ceftriaxone, and piperacillin-tazobactam.
  
  
  CONCLUSIONS
  Device-associated nosocomial infections was a particularly important problem in NICU. Close monitoring will decrease the rates of device-related nosocomial infections.
authors: Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. Electronic address: rectek21@hotmail.com.
authors: Recep
authors: R
authors: Tekin
authors: Tuba
authors: T
authors: Dal
authors: Habibe
authors: H
authors: Pirinccioglu
authors: Seyhan Erisir
authors: SE
authors: Oygucu
mesh_terms: D040981:Acinetobacter baumannii / Q000302:isolation & purification; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology* / Q000382:microbiology; D011446:Prospective Studies; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification
keywords: device-associated health care-associated infection; neonatal intensive care unit; nosocomial infection; ventilator-associated pneumonia