Four years of surveillance data on healthcare-associated infections in high-risk newborns

Objective: Healthcare-associated infections (HAIs) are a major issue in neonatal intensive care units (NICUs). The characteristics of HAIs and the distribution of pathogens might also vary. HAI surveillance is important for infection control to determine HAI rates and pathogen characteristics. The purpose of this study was to assess the rates of HAIs, distribution of HAI types, characteristics of the pathogens, and antibiotic susceptibility in the first four years of a newly opened NICU.
Method: In the NICU of Marmara University Pendik Training and Research Hospital, the infection control team identified HAIs and recorded the National Hospital Infection Surveillance Network in accordance with the standards of the Centers for Disease Control and Prevention throughout the period of four years after the unit’s opening. All patients in the first four years of the NICU were included in the study. The capacity of the NICU is 16 incubators and the average nurse/neonate ratio was 1/3 in this period.
Results: During the 4-year study period, 1301 patients were hospitalized in the NICU and 378 HAIs were detected. The overall HAI rate was 29.1% and the density was 21.8 per 1000 patient days. Neonatal groups with birth weights of 750 grams and 751–1000 grams had the highest rates and incidence density of HAIs. The most common HAI pathogens were Klebsiella spp. (27.8%), Staphylococcus spp. (26.2%), Acinetobacter baumannii (5.8%), and Escherichia coli (5.8%).
Conclusion: The risk of HAIs was found to be higher in neonates with a birth weight <1000 grams. In places where HAI rates are high such as NICUs, analyzing the characteristics of HAIs with active surveillance data is an essential component of infection control. This could enhance patient care and increase the survival of preterm infants with low birth weight.