scholarly journals Health care-associated infection surveillance: A prospective study of a tertiary neonatal intensive care unit

2019 ◽  
Vol 13 (03) ◽  
pp. 181-187 ◽  
Author(s):  
Atila Kilic ◽  
Emel Okulu ◽  
Bilge Aldemir Kocabas ◽  
Serdar Alan ◽  
Ufuk Cakir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Intensive Care ◽  
Mortality Rate ◽  
Neonatal Intensive Care ◽  
Blood Stream Infection ◽  
Venous Catheter ◽  
Care Quality ◽  
Multivariable Logistic Regression Analysis ◽  
Health Care Associated Infection

Introduction: Health care-associated infection (HCAI) is a serious problem of neonatal intensive care units (NICUs) which is related to morbidity, mortality and increased cost of medical care. This study aimed to determine the incidence of HCAI in a tertiary NICU and identify the risk factors. Methodology: This prospective cohort study was conducted between July 1, 2011 and June 30, 2012. All newborns admitted to the NICU except for those who died or were discharged within 48 hours after admission were included. The definitions of Centers for Disease Control and Prevention (CDC) were used to diagnose specific types of infections. The incidence, causative organisms, risk factors and mortality of HCAIs were evaluated. Results: Among 352 newborns, a total of 60 HCAI episodes were evaluated in 37 (10.5%) of the patients over 5,212 patient-days. The overall incidence of HCAI was 17%, and the rate was 11.5/1,000 patient-days. Blood stream infection (BSI) was the most common HCAI (n = 42, 70%). In a multivariable logistic regression analysis, the presence of a central venous catheter/umbilical catheter (CVC/UC), the presence of a urinary catheter, and gestational age (< 32 weeks of gestation) were identified as significant independent risk factors. Gram-negative pathogens were the most common isolates. The overall mortality rate was 4%. The HCAI-related mortality rate was 10.8%. Conclusions: Patient care quality can be improved with surveillance of HCAI. The incidence and rate of HCAI in our NICU were found to be higher than international reports with a direct impact on mortality of preterm infants.

scholarly journals Risk Factors of Central Venous Catheter Leakage in Neonatal Intensive Care Unit

Perinatology ◽  
2019 ◽  
Vol 30 (2) ◽  
pp. 60 ◽  
Author(s):  
Young Duck Kim ◽  
Na Mi Lee ◽  
Su Yeong Kim ◽  
Dae Yong Yi ◽  
Sin Weon Yun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Central Venous Catheter ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Venous Catheter ◽  
Central Venous

scholarly journals Seasonality, Epidemiology and Outcome of Congenital Diaphragmatic Hernia in South West of Iran

2017 ◽  
Vol 6 (2) ◽  
pp. 28 ◽  
Author(s):  
Masoud Dehdashtian ◽  
Shiva Bashirnejad ◽  
Arash Malekian ◽  
Mohammad Reza Aramesh ◽  
Mohammad Hasan Aletayeb
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Seasonal Variation ◽  
Mortality Rate ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Neonatal Intensive Care ◽  
South West ◽  
Very High

Introduction: The pathogenesis of congenital diaphragmatic hernia (CDH) is not clear. Risk factors including environmental factors have been implicated in the pathogenesis of few congenital anomalies. We aimed to assess the effect of season on the incidence of CDH and mortality rate in the southwest of Iran.Material and Methods: In this retrospective study, the records of 60 patients with CDH who were admitted at Neonatal Intensive Care Unit (NICU) of Imam Khomeini Hospital of Ahvaz, Iran were evaluated.Results: Assuming that all the neonates born with CDH in the region reach this hospital, overall CDH prevalence rate was 1.09 per 10 000 total births. Conceptions in spring and summer in this region had statistically significantly higher incidence of CDH. Survival rate in the series was 41.6%.Conclusion: Seasonal variation has impact on the incidence of CDH. Mortality rate in neonates with CDH is still very high.

scholarly journals Risk Factors for Health Care-Associated Bloodstream Infections in a Neonatal Intensive Care Unit

2016 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Sabahattin Ertugrul ◽  
Fesih Aktar ◽  
Ilyas Yolbas ◽  
Ahmet Yilmaz ◽  
Bilal Elbey ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Bloodstream Infections

scholarly journals Incidence and Determinants of Health Care Associated Blood Stream Infection at a Neonatal Intensive Care Unit in Ujjain, India: A Prospective Cohort Study

2017 ◽  
Author(s):  
Mamta Dhaneria ◽  
Sachin Jain ◽  
Poonam Singh ◽  
Aditya Mathur ◽  
Cecilia Stålsby Lundborg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Extended Spectrum Beta Lactamase ◽  
Medical College ◽  
Resource Limited ◽  
Causative Agents

Very little is known about healthcare-associated infections (HAIs) in neonatal intensive care units (NICUs) in resource-limited settings including, India. The aim of this prospective study was to determine the prevalence, onset, risk factors and causative agents of laboratory confirmed blood stream (LBCI) as a HAI in a level-2 NICU at RD Gardi Medical College, Ujjain, India. The diagnosis of HAI was established using the Centre for Disease Control, USA criteria. A predesigned questionnaire containing risk factors associated with BSHAI was filled. A total of 150 neonates (43% preterm) were included in the study. The incidence of LBCI was 31%; 56% of which was late onset sepsis. The independent risk factors for LBCI were: preterm (Odds Ratio OR 3.22), duration of NICU stay more than 14 days (OR 2.38), chorioamnionitis in the mother (OR 18.48), neonate born through meconium stained amniotic fluid (OR 4.53), mal-presentation (OR 10.58), endotracheal intubation (OR 11.60), umbilical catheterization (OR 15.11), HAI due to ventilator-associated pneumonia (VAP) (OR 11.88). Initiation of minimal enteral nutrition was protective (OR 0.15). The predominant causative organisms were Gram-negative pathogens (58%). Among Klebsiella spp. and E. coli isolates, 73 and 80%, respectively were identified as extended-spectrum beta-lactamase producers. The results can be used to identify high-risk neonates for LBCI.

Nosocomial Infection Outbreak with Enterobacter aerogenes at a Neonatal Intensive Care Unit and Its Outcomes

2019 ◽  
Vol 14 (05) ◽  
pp. 223-227 ◽  
Author(s):  
Dilek Ulubaş Işık ◽  
Ahmet Yagmur Bas ◽  
Ferit Kulali ◽  
Beyza Ozcan ◽  
Sezin Unal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Enterobacter Aerogenes ◽  
Morbidity And Mortality ◽  
Prevention Measures ◽  
Objective Health

Objective Health care associated infections (HAIs) in the neonatal intensive care unit (NICU) are a significant cause of neonatal morbidity and mortality. Enterobacter aerogenes, a gram-negative bacterium, rarely causes HAI in the pediatric and NICUs. We report the case of a HAI outbreak of E. aerogenes in an NICU and discuss the clinical spectrum and outcome of the affected preterm newborns and successful prevention measures. Materials and Methods A retrospective study was conducted in a level III NICU of Etlik Zubeyde Hanım Women's Health Teaching and Research Hospital. The infants with blood cultures positive for E. aerogenes during the outbreak were enrolled. Perinatal risk factors, laboratory findings, symptoms, treatment, and prognosis were recorded. Clinical applications and prevention measures were identified. Results A preterm infant of 27 weeks of gestation who was diagnosed on the eighth postnatal day was the initial case of the reported outbreak of health care associated E. aerogenes infection. Subsequently, 12 more infants were diagnosed in the next 3 months. Infants' mean gestational age was 27.1 ± 2.3 weeks, and mean birthweight was 902 ± 161 g. The clinical symptoms at presentation were respiratory distress, sclerema, circulatory failure, and shock, which appeared at a mean age of 7.6 ± 5.8 days. Analysis of E. aerogenes strains revealed that all strains were of the same clonal type. Eight patients died in follow-up due to E. aerogenes septicemia during this outbreak. The mean interval between the onset of symptoms and death was 1.5 ± 1 days. Conclusion Outbreaks of health care associated E. aerogenes infection result in a high mortality rate among very low birthweight infants. Awareness of adjustable risk factors and preventive measures to control the outbreak decreases both morbidity and mortality.

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