title: Infection prevention practices in neonatal intensive care units reporting to the national healthcare safety network.
abstract: BACKGROUND
  Patients in the neonatal intensive care unit (NICU) are at high risk for healthcare-associated infections. Variability in reported infection rates among NICUs exists, possibly related to differences in prevention strategies. A better understanding of current prevention practices may help identify prevention gaps and areas for further research.
  
  
  METHODS
  We surveyed infection control staff in NICUs reporting to the National Healthcare Safety Network (NHSN) to assess strategies used to prevent methicillin-resistant Staphylococcus aureus (MRSA) transmission and central line-associated bloodstream infections in NICUs.
  
  
  RESULTS
  Staff from 162 of 342 NICUs responded (response rate, 47.3%). Most (92.3%) NICUs use central line insertion and maintenance bundles, but maintenance practices varied, including agents used for antisepsis and frequency of dressing changes. Forty-two percent reported routine screening for MRSA colonization upon admission for all patients. Chlorhexidine gluconate (CHG) use for central line care for at least 1 indication (central line insertion, dressing changes, or port/cap antisepsis) was reported in 82 NICUs (51.3%). Among sixty-five NICUs responding to questions on CHG use restrictions, 46.2% reported no restrictions.
  
  
  CONCLUSIONS
  Our survey illustrated heterogeneity of CLABSI and MRSA prevention practices and underscores the need for further research to define optimal strategies and evidence-based prevention recommendations for neonates.
authors.affiliation: Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Susan N
authors.initials: SN
authors.lastname: Hocevar
authors.forename: Fernanda C
authors.initials: FC
authors.lastname: Lessa
authors.forename: Lauren
authors.initials: L
authors.lastname: Gallagher
authors.forename: Craig
authors.initials: C
authors.lastname: Conover
authors.forename: Rachel
authors.initials: R
authors.lastname: Gorwitz
authors.forename: Martha
authors.initials: M
authors.lastname: Iwamoto
mesh_terms: D016470:Bacteremia / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000517:prevention & control*; D003428:Cross Infection / Q000517:prevention & control*; D019538:Health Care Surveys; D006801:Humans; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods* / Q000706:statistics & numerical data; D007363:Intensive Care Units, Neonatal; D055624:Methicillin-Resistant Staphylococcus aureus; D013203:Staphylococcal Infections / Q000517:prevention & control*; D014481:United States
references.citation: J Perinatol. 2010 Mar;30(3):170-81
references.pmid: 19940855
references.citation: Curr Opin Infect Dis. 2009 Jun;22(3):224-8
references.pmid: 19369867
references.citation: J Hosp Infect. 2001 May;48(1):20-6
references.pmid: 11358467
references.citation: Infect Control Hosp Epidemiol. 2009 Jul;30(7):645-51
references.pmid: 19496731
references.citation: Infect Control Hosp Epidemiol. 2010 Jul;31(7):766-8
references.pmid: 20470034
references.citation: Clin Infect Dis. 2011 May;52(9):e162-93
references.pmid: 21460264
references.citation: Am J Epidemiol. 2010 Dec 1;172(11):1292-8
references.pmid: 20880962
references.citation: Pediatrics. 2011 Mar;127(3):419-26
references.pmid: 21339273
references.citation: Infect Control Hosp Epidemiol. 2013 Nov;34(11):1208-10
references.pmid: 24113607
references.citation: Am J Infect Control. 1993 Feb;21(1):16-20
references.pmid: 8442517
references.citation: Am J Infect Control. 2007 Dec;35(10 Suppl 2):S165-93
references.pmid: 18068814
references.citation: JAMA. 2009 Feb 18;301(7):727-36
references.pmid: 19224749
references.citation: Pediatrics. 2010 Feb;125(2):206-13
references.pmid: 20064860
references.citation: J Perinatol. 2010 Feb;30(2):135-9
references.pmid: 19710681
references.citation: J Clin Microbiol. 2001 Jun;39(6):2294-7
references.pmid: 11376074
references.citation: Pediatr Infect Dis J. 2009 Jul;28(7):577-81
references.pmid: 19478687
references.citation: Am J Infect Control. 2011 Jun;39(5):349-67
references.pmid: 21774120
references.citation: Infect Control Hosp Epidemiol. 2010 Nov;31 Suppl 1:S27-31
references.pmid: 20929363
references.citation: Infect Control Hosp Epidemiol. 2010 Aug;31(8):846-9
references.pmid: 20586654
references.citation: Pediatrics. 2011 Mar;127(3):436-44
references.pmid: 21339265