title: Nosocomial infections in a neonatal intensive care unit during 16 years: 1997-2012.
abstract: BACKGROUND
  Surveillance of nosocomial infections (NIs) is an essential part of quality patient care; however, there are few reports of National Healthcare Safety Network (NHSN) surveillance in neonatal intensive care units (NICUs) and none in developing countries. The purpose of this study was to report the incidence of NIs, causative organisms, and antimicrobial susceptibility patterns in a large cohort of neonates admitted to the NICU during a 16-year period.
  
  
  METHODS
  The patients were followed 5 times per week from birth to discharge or death, and epidemiological surveillance was conducted according to the NHSN.
  
  
  RESULTS
  From January 1997 to December 2012, 4,615 neonates, representing 62,412 patient-days, were admitted to the NICU. The device-associated infection rates were as follows: 17.3 primary bloodstream infections per 1,000 central line-days and 3.2 pneumonia infections per 1,000 ventilator-days. A total of 1,182 microorganisms were isolated from sterile body site cultures in 902 neonates. Coagulase-negative staphylococci (CoNS) (34.3%) and Staphylococcus aureus (15.6%) were the most common etiologic agents isolated from cultures. The incidences of oxacillin-resistant CoNS and Staphylococcus aureus were 86.4% and 28.3%, respectively.
  
  
  CONCLUSIONS
  The most important NI remains bloodstream infection with staphylococci as the predominant pathogens, observed at much higher rates than those reported in the literature. Multiresistant microorganisms, especially oxacillin-resistant staphylococci and gram-negative bacilli resistant to cephalosporin were frequently found. Furthermore, by promoting strict hygiene measures and meticulous care of the infected infants, the process itself of evaluating the causative organisms was valuable.
authors: Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.
authors: Jane Eire
authors: JE
authors: Urzedo
authors: Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.
authors: Maria Margarida Morena Domingos
authors: MM
authors: Levenhagen
authors: Escola Técnica de Saúde, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.
authors: Reginaldo Santos
authors: RS
authors: Pedroso
authors: Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.
authors: Vânia Olivetti Steffen
authors: VO
authors: Abdallah
authors: Hospital de Clínicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.
authors: Sebastiana Silva
authors: SS
authors: Sabino
authors: Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil.
authors: Denise Von Dolinger
authors: DV
authors: Brito
mesh_terms: D001938:Brazil / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D006090:Gram-Negative Bacteria / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D012307:Risk Factors