title: Risk Factors for Health Care-Associated Bloodstream Infections in a Neonatal Intensive Care Unit.
abstract: BACKGROUND
  Healthcare-associated bloodstream infections (HCA-BSI) are a major cause of morbidity and mortality in neonatal intensive care units (NICUs).
  
  
  OBJECTIVE
  We aimed to determine the causative organisms and risk factors of HCA-BSIs in NICUs.
  
  
  METHODS
  This study was performed between January 2011 and December 2014 in the neonatal intensive care unit of Dicle university, Turkey. The study consisted of 126 patients (infected group) with positive blood culture and 126 randomly selected patients (uninfected control group) with negative blood culture after four days of hospitalization.
  
  
  RESULTS
  We found that the most common causative agents isolated from nosocomial infections (NIs) were 20.7%Staphylococcus epidermidis, 26.7%Klebsiellaspp., and 13.3%Acinetobacterspp. Incidences of low gestational age, low birth weight, vaginal birth type, and long length of hospitalization were higher in the infected neonates than in the uninfected neonates. In the univariate analysis, surgical operation, ventriculoperitoneal shunt, use of umbilical catheter, nasogastric or orogastric tube, urinary catheter, mechanical ventilation, surfactant treatment, erythrocyte transfusion, plasma transfusion, thrombocyte transfusion, total parenteral nutrition infusion, intracranial hemorrhage, length of hospital stay, fifth-minute Apgar score, and total parenteral nutrition time were significantly associated with NIs. In the multiple logistic regression analysis, fifth-minute Apgar, use of erythrocyte transfusion and surgical operation were found as the independent risk factors for HCA-BSI.
  
  
  CONCLUSIONS
  This study determined the causative organisms and risk factors of HCA-BSIs in NICUs.
authors.affiliation: Department of Neonatology, Medical Faculty, Dicle University, Diyarbakir, Turkey.
authors.forename: Sabahattin
authors.initials: S
authors.lastname: Ertugrul
authors.affiliation: Department of Pediatric Infectious Disease, Medical Faculty, Dicle University, Diyarbakir, Turkey.
authors.forename: Fesih
authors.initials: F
authors.lastname: Aktar
authors.affiliation: Department of Pediatrics, Medical Faculty, Dicle University, Diyarbakir, Turkey.
authors.forename: Ilyas
authors.initials: I
authors.lastname: Yolbas
authors.affiliation: Department of Family Medicine, Medical Faculty, Dicle University, Diyarbakir, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Yilmaz
authors.affiliation: Department of Immunology, Medical Faculty, Dicle University, Diyarbakir, Turkey.
authors.forename: Bilal
authors.initials: B
authors.lastname: Elbey
authors.affiliation: Department of Pediatrics, Medical Faculty, Dicle University, Diyarbakir, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Yildirim
authors.affiliation: Department of Pediatrics, Medical Faculty, Dicle University, Diyarbakir, Turkey.
authors.forename: Kamil
authors.initials: K
authors.lastname: Yilmaz
authors.affiliation: Clinical Microbiology and Infectious Disease, Medical Faculty, Dicle University, Diyarbakir, Turkey.
authors.forename: Recep
authors.initials: R
authors.lastname: Tekin
keywords: Bloodstream Infections; Healthcare-Associated Infections; Neonates; Risk Factors