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Prevalence of Newborn Intensive Care Unit-Acquired, Healthcare-Associated Blood-Stream Infections in Neonatal Intensive Care Unit Patients: Results From The First National Point-Prevalence Survey

Year 2015, Volume: 40 Issue: 1, 119 - 128, 09.09.2015
https://doi.org/10.17826/cutf.25310

Abstract

Purpose: Patients admitted to neonatal intensive care units (NICUs) are at high risk of Healthcare-Associated Bloodstream Infection (HABSI). We conducted a national multicenter assessment of HABSI in NICUs to determine the prevalence of infections and describe associated risk factors. Araştırma Makalesi / Research Article 119 Çağan ve ark. Cukurova Medical Journal Material and Methods: We conducted a point prevalence survey of HABSI in 38 NICUs. Patients present on the survey date were included. Data on demographics, underlying diagnoses, therapeutic interventions/treatments, infections, and outcomes were collected for all NICU patients. Results: A total of 933 patients in 38 NICUs participated in the study, 142 of whom had HABSI, corresponding to a prevalence of 15.2%. The reported HABSI were clinical sepsis (n=88, 61.9%), laboratory-confirmed bloodstream infection (n=50, 35.2%) and catheter related infection (n = 4, 2.9%). Causative microorganisms were isolated in 54 (38%) patients with HABSI. The most common causative pathogens were coagulase negative Staphylococcus (n=34, 25.7%) and Candida spp. (n=10, 7%). The risk factors for HABSI were total parenteral nutrition, nasogastric feeding tube, central venous catheter, absence of High Efficiency Particulate Air (HEPA), gastrointestinal system disease, carrying out the preventive application bundle for catheter related infections, absence of next to each incubator disinfectant, duration of hospitalization more than 3 days and post-natal age more than 30 days. At 4-week follow up, 33 (3.5%) patients had died, 13 (39.3%) of whom died from healthcare-associated infections. HABSI were not found to be risk factors for death (p>0.05). Conclusion: This national multicenter study documented the high prevalence of NICU-acquired infections. Preventing these infections should be national priority

References

  • Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36:309-32.
  • Sohn AH, Garrett DO, Sinkowitz-Cochran RL, Grohskopf LA, Levine GL, Stover BH, et al. Prevalence of nosocomial infections in neonatal intensive care unit patients: Results from the first national point-prevalence survey. J Pediatr. 2001;139:821-7.
  • Yapicioglu H, Satar M, Ozcan K, Narli N, Ozlu F, Sertdemir Y, et al. A 6-year prospective surveillance of healthcare-associated infections in a neonatal intensive care unit from southern part of Turkey. J Paediatr Child Health. 2010;46:337-42.
  • Bas AY, Demirel N, Zenciroglu A, Gol N, Tanir G. Nosocomial blood stream infections in a neonatal intensive care unit in Ankara, Turkey. Turk J Pediatr. 2010;52:464-70.
  • Meral C . Neonatal Sepsis Olgularının ve Etkenlerinin
  • Retrospektif Değerlendirilmesi. TAF Preventive Medicine Bulletin. 2009;8:329-32.
  • Nosocomial infections in neonatal units in Turkey: epidemiology, problems, unit policies and opinions of healthcare workers. Turk J Pediatr. 2010;52:50-7.
  • O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control. 2011;39:1-34.
  • Edwards JR, Peterson KD, Andrus ML, Tolson JS, Goulding JS, Dudeck MA, et al. National Healthcare Safety Network (NHSN) Report, data summary for 2006, issued June 2007. Am J Infect Control. 2007;35:290-301.
  • UHESA 2012 Resmi Verileri. http://uhes.saglik.gov.tr . 2012. Ref Type: Online Source
  • Saiman L, Ludington E, Pfaller M, Rangel-Frausto S, Wiblin RT, Dawson J, et al. Risk factors for candidemia in Neonatal Intensive Care Unit patients. The National Epidemiology of Mycosis Survey study group. Pediatr Infect Dis J. 2000;19:319-24.
  • Stoll BJ, Temprosa M, Tyson JE, Papile LA, Wright LL, Bauer CR, et al. Dexamethasone therapy increases infection in very low birth weight infants. Pediatrics. 1999;104:e63.
  • Papile LA, Tyson JE, Stoll BJ, Wright LL, Donovan EF, Bauer CR, et al. A multicenter trial of two dexamethasone regimens in ventilator-dependent premature infants. N Engl J Med. 1998;338:1112-8.
  • Beck-Sague CM, Azimi P, Fonseca SN, Baltimore RS, Powell DA, Bland LA, et al. Bloodstream infections in neonatal intensive care unit patients: results of a multicenter study. Pediatr Infect Dis J. 1994;13:1110-6.
  • Brodie SB, Sands KE, Gray JE, Parker RA, Goldmann DA, Davis RB, et al. Occurrence of nosocomial bloodstream infections in six neonatal intensive care units. Pediatr Infect Dis J. 2000;19:56- 65.
  • Holmes A, Dore CJ, Saraswatula A, Bamford KB, Richards MS, Coello R, et al. Risk factors and recommendations for rate stratification for surveillance of neonatal healthcare-associated bloodstream infection. J Hosp Infect. 2008;68:66-72.
  • Gaynes RP, Edwards JR, Jarvis WR, Culver DH, Tolson JS, Martone WJ. Nosocomial infections among neonates in high-risk nurseries in the United States. National Nosocomial Infections Surveillance System. Pediatrics. 1996;98:357-61.
  • Remington JS. Infectious diseases of the fetus and newborn infant. 2006;6th ed.
  • Yalaz M, Altun-Koroglu O, Ulusoy B, Yildiz B, Akisu M, Vardar F, et al. Evaluation of device-associated infections in a neonatal intensive care unit. Turk J Pediatr 2012; 54:128-35.
  • Moloney AC, Quoraishi AH, Parry P, Hall V. A bacteriological examination of breast pumps. J Hosp Infect. 1987;9:169-74.
  • Leigh L, Stoll BJ, Rahman M, McGowan J, Jr. Pseudomonas aeruginosa infection in very low birth weight infants: a case-control study. Pediatr Infect Dis J. 1995;14:367-71.
  • Nakano M, Miyazawa H, Kawano Y, Kawagishi M, Torii K, Hasegawa T, et al. An outbreak of neonatal toxic shock syndrome-like exanthematous disease (NTED) caused by methicillin-resistant Staphylococcus aureus (MRSA) in a neonatal intensive care unit. Microbiol Immunol. 2002;46:277- 84.
  • Bakır M SA. Pediatride Nozokomiyal Enfeksiyonlar, Tanı, Tedavi ve Koruma. 1. Basım ed. Ankara: Bilimsel Tıp Yayınevi; 2003.

Yenidoğan Yoğunbakım Ünitelerinde Sağlık Hizmeti İlişkili Kan Akım Enfeksiyonlarının Prevalansı; İlk Ulusal Nokta Prevalans Çalışmasının Sonuçları

Year 2015, Volume: 40 Issue: 1, 119 - 128, 09.09.2015
https://doi.org/10.17826/cutf.25310

Abstract

Amaç: Yenidoğan yoğun bakım ünitelerinde (YYBÜ) yatan hastalar sağlık hizmeti ilişki (SHİE) enfeksiyomlar için yüksek risk altındadır. Biz ulusal çok merkezli bu çalışmada sağlık hizmeti ilişkili kan akım enfeksiyonun (SHİKAE) prevalansını ve eşlik eden risk faktörlerini değerlendirdik. Materyal ve Metod: Biz 38 YYBÜ’de SHİKAE için nokta prevalans çalışması yaptık. Anket tarihinde yatmakta olan hastalar çalışmaya dahil edildi. Bulgular: SHİKAE’lerin %61.9’u (n=88) klinik sepsis, %35.2’si (n=50) laboratuar konfirme kan akım enfeksiyonu ve %2.9’u (n=4) kateter ile ilişkili kan akım enfeksiyonuydu. SHİKAE olan hastaların %38’inde (n=54) etken mikroorganizmalar tespit edildi. En sık tespit edilen etken patojenler; kogagülaz negative stafilokok (n=34, 25.7%), Candida spp. (n=10, 7%) idi. Total parenteral nutrisyon, nazogastrik sonda, santral venöz kateter, High Efficiency Particulate Air (HEPA) yokluğu, gastrointestinal sistem hastalığı, kateter ile ilişkili enfeksiyonları önlemek için bundle uygulamasının yapılmaması, her bir küvez başında el dezenfektanının olmaması, yatış süresinin üç günden fazla olması ve hasta yaşının 30 günden fazla olması SHİKAE için risk faktörü olarak tespit edildi. Dört haftalık izlem sonucunda 33 hasta (%3.5) öldü, bu hastaların 13’ü (%39.3) SHİE nedeniyle öldüü tespit edildi. SHİKAE ölüm için risk faktörü olarak tespit edilmedi. Sonuç: Çok merkezli bu çalışma göstermiştir ki YYBÜ kaynaklı enfeksiyonların prevalansı yüksektir. Bu enfeksiyonların önlenmesi ulusal öncelik olmalıdır

References

  • Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36:309-32.
  • Sohn AH, Garrett DO, Sinkowitz-Cochran RL, Grohskopf LA, Levine GL, Stover BH, et al. Prevalence of nosocomial infections in neonatal intensive care unit patients: Results from the first national point-prevalence survey. J Pediatr. 2001;139:821-7.
  • Yapicioglu H, Satar M, Ozcan K, Narli N, Ozlu F, Sertdemir Y, et al. A 6-year prospective surveillance of healthcare-associated infections in a neonatal intensive care unit from southern part of Turkey. J Paediatr Child Health. 2010;46:337-42.
  • Bas AY, Demirel N, Zenciroglu A, Gol N, Tanir G. Nosocomial blood stream infections in a neonatal intensive care unit in Ankara, Turkey. Turk J Pediatr. 2010;52:464-70.
  • Meral C . Neonatal Sepsis Olgularının ve Etkenlerinin
  • Retrospektif Değerlendirilmesi. TAF Preventive Medicine Bulletin. 2009;8:329-32.
  • Nosocomial infections in neonatal units in Turkey: epidemiology, problems, unit policies and opinions of healthcare workers. Turk J Pediatr. 2010;52:50-7.
  • O'Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Am J Infect Control. 2011;39:1-34.
  • Edwards JR, Peterson KD, Andrus ML, Tolson JS, Goulding JS, Dudeck MA, et al. National Healthcare Safety Network (NHSN) Report, data summary for 2006, issued June 2007. Am J Infect Control. 2007;35:290-301.
  • UHESA 2012 Resmi Verileri. http://uhes.saglik.gov.tr . 2012. Ref Type: Online Source
  • Saiman L, Ludington E, Pfaller M, Rangel-Frausto S, Wiblin RT, Dawson J, et al. Risk factors for candidemia in Neonatal Intensive Care Unit patients. The National Epidemiology of Mycosis Survey study group. Pediatr Infect Dis J. 2000;19:319-24.
  • Stoll BJ, Temprosa M, Tyson JE, Papile LA, Wright LL, Bauer CR, et al. Dexamethasone therapy increases infection in very low birth weight infants. Pediatrics. 1999;104:e63.
  • Papile LA, Tyson JE, Stoll BJ, Wright LL, Donovan EF, Bauer CR, et al. A multicenter trial of two dexamethasone regimens in ventilator-dependent premature infants. N Engl J Med. 1998;338:1112-8.
  • Beck-Sague CM, Azimi P, Fonseca SN, Baltimore RS, Powell DA, Bland LA, et al. Bloodstream infections in neonatal intensive care unit patients: results of a multicenter study. Pediatr Infect Dis J. 1994;13:1110-6.
  • Brodie SB, Sands KE, Gray JE, Parker RA, Goldmann DA, Davis RB, et al. Occurrence of nosocomial bloodstream infections in six neonatal intensive care units. Pediatr Infect Dis J. 2000;19:56- 65.
  • Holmes A, Dore CJ, Saraswatula A, Bamford KB, Richards MS, Coello R, et al. Risk factors and recommendations for rate stratification for surveillance of neonatal healthcare-associated bloodstream infection. J Hosp Infect. 2008;68:66-72.
  • Gaynes RP, Edwards JR, Jarvis WR, Culver DH, Tolson JS, Martone WJ. Nosocomial infections among neonates in high-risk nurseries in the United States. National Nosocomial Infections Surveillance System. Pediatrics. 1996;98:357-61.
  • Remington JS. Infectious diseases of the fetus and newborn infant. 2006;6th ed.
  • Yalaz M, Altun-Koroglu O, Ulusoy B, Yildiz B, Akisu M, Vardar F, et al. Evaluation of device-associated infections in a neonatal intensive care unit. Turk J Pediatr 2012; 54:128-35.
  • Moloney AC, Quoraishi AH, Parry P, Hall V. A bacteriological examination of breast pumps. J Hosp Infect. 1987;9:169-74.
  • Leigh L, Stoll BJ, Rahman M, McGowan J, Jr. Pseudomonas aeruginosa infection in very low birth weight infants: a case-control study. Pediatr Infect Dis J. 1995;14:367-71.
  • Nakano M, Miyazawa H, Kawano Y, Kawagishi M, Torii K, Hasegawa T, et al. An outbreak of neonatal toxic shock syndrome-like exanthematous disease (NTED) caused by methicillin-resistant Staphylococcus aureus (MRSA) in a neonatal intensive care unit. Microbiol Immunol. 2002;46:277- 84.
  • Bakır M SA. Pediatride Nozokomiyal Enfeksiyonlar, Tanı, Tedavi ve Koruma. 1. Basım ed. Ankara: Bilimsel Tıp Yayınevi; 2003.
There are 23 citations in total.

Details

Primary Language English
Journal Section Research
Authors

Eren Çağan This is me

Ahmet Soysal This is me

Mustafa Bakır This is me

Eren Özek This is me

Publication Date September 9, 2015
Published in Issue Year 2015 Volume: 40 Issue: 1

Cite

MLA Çağan, Eren et al. “Prevalence of Newborn Intensive Care Unit-Acquired, Healthcare-Associated Blood-Stream Infections in Neonatal Intensive Care Unit Patients: Results From The First National Point-Prevalence Survey”. Cukurova Medical Journal, vol. 40, no. 1, 2015, pp. 119-28, doi:10.17826/cutf.25310.