title: Health care-associated infection surveillance in a tertiary neonatal intensive care unit: A prospective clinical study after moving to a new building.
abstract: BACKGROUND
  There are very few prospective clinical studies on neonatal health care-associated infection (HAI) surveillance. HAI surveillance helps reduce not only mortality, but also morbidity, length of hospital stay, and health care costs.
  
  
  METHODS
  This prospective clinical study covered a period of 12 months in a tertiary neonatal intensive care unit (NICU). HAI rates were calculated using different denominators: number of patients hospitalized in the NICU, number of patient-days, and number of specific device-days.
  
  
  RESULTS
  The HAI rate was 18%, and the incidence density was 17/1,000 patient-days. The most common HAI was bloodstream infection (n = 34; 50%). The most common pathogen was coagulase-negative staphylococci (CoNS; 54.9%) in gram-positive bacteria and in general. Methicillin resistance was 96.4% for CoNS. Klebsiella spp (13.7%) was the most common gram-negative bacteria. Extended-spectrum β-lactamase positivity was 14.3% for Klebsiella spp and 25% for Escherichia coli. HAI-related mortality was 0.3%.
  
  
  CONCLUSIONS
  NICUs should perform their own HAI surveillance with prospective clinical design. Attention paid to handwashing, disinfection and sanitizing, complying with the terms of asepsis, extending in-service training, increasing the number of medical staff, preventing frequent changes in health care staff positions, and improving physical environmental conditions in NICUs might eventually decrease HAI rates.
authors: Department of Pediatrics, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey. Electronic address: ceyhun_cura@yahoo.com.tr.
authors: Ceyhun
authors: C
authors: Cura
authors: Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Acibadem University, Istanbul, Turkey.
authors: Metehan
authors: M
authors: Ozen
authors: Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
authors: Aybuke
authors: A
authors: Akaslan Kara
authors: Division of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
authors: Gulsum
authors: G
authors: Alkan
authors: Department of Medical Microbiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
authors: Emel
authors: E
authors: Sesli Cetin
mesh_terms: D003428:Cross Infection / Q000453:epidemiology*; D004203:Disinfection; D062665:Epidemiological Monitoring; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006094:Gram-Positive Bacteria / Q000302:isolation & purification*; D006235:Hand Disinfection; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay; D008297:Male; D011446:Prospective Studies; D012499:Sanitation; D062606:Tertiary Care Centers; D014421:Turkey / Q000453:epidemiology; D015003:Yeasts / Q000302:isolation & purification*
keywords: Health care–associated infection surveillance; Neonatal intensive care unit; Prevention; Relocation