Trends, risk factors and outcomes of healthcare-associated infections in a neonatal intensive care unit in Italy during 2013–2017.
Background: Healthcare-associated infections (HAIs) occur frequently in intensive care units (NICUs). The aim of this study was to analyze the results of surveillance of HAIs in a III level NICU in Naples, Italy during 2013–2017 and to compare with those obtained during 2006–2010. Methods: The surve...
| Publicado en: | Italian Journal of Pediatrics Vol. 46; no. 1; pp. 1 - 11 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
BioMed Central
3/18/2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=142293630&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 142293630 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17208424 1D4R jtl: Italian Journal of Pediatrics issn: 17208424 maglogo: N pubinfo: dt: 3/18/2020 vid: 46 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 142293630 142293630 142293630 10.1186/s13052-020-0799-3 142293630 ppf: 1 ppct: 10 formats: tig: atl: Trends, risk factors and outcomes of healthcare-associated infections in a neonatal intensive care unit in Italy during 2013–2017. aug: au: Scamardo, Marina Silvia Dolce, Pasquale Esposito, Eliana Pia Raimondi, Francesco Triassi, Maria Zarrilli, Raffaele affil: Department of Public Health, University of Naples "Federico II", Via S. Pansini n.5, 80131, Naples, Italy sug: subj: Cross Infection Trends Cross Infection Risk Factors Outcome Assessment Intensive Care Units, Neonatal Italy Disease Surveillance Human Italy Surveys Comparative Studies Centers for Disease Control and Prevention (U.S.) Infant Physiology Birth Weight Catheter-Related Bloodstream Infections Pneumonia, Ventilator-Associated Urinary Tract Infections Enterocolitis, Necrotizing Staphylococcal Infections Candida Pseudomonas Escherichia Coli Klebsiella Gram-Positive Bacterial Infections Gram-Negative Bacterial Infections Descriptive Statistics ab: Background: Healthcare-associated infections (HAIs) occur frequently in intensive care units (NICUs). The aim of this study was to analyze the results of surveillance of HAIs in a III level NICU in Naples, Italy during 2013–2017 and to compare with those obtained during 2006–2010. Methods: The surveillance included 1265 neonates of all birth weight (BW) classes with > 2 days NICU stay. Infections were defined using standard Centers for Disease Control and Prevention definitions adapted to neonatal pathology. Results: A total of 125 HAIs were registered during 2013–2017 with a frequency of 9.9% and an incidence density of 3.2 per 1000 patient days. HAIs occurred in all BW classes with a decreasing trend from the lowest to the highest BW classes (p = < 0.001). Central line-associated blood stream infection (CLABSI) was the most frequent infection (69.6%), followed by ventilator associated pneumonia (VAP) (20%), urinary tract infection (UTI) (8.8%) and necrotizing enterocolitis (NEC) (1.6%). Also, CLABSI and VAP incidence density decreased from lower to highest BW classes showing a significant trend (p = 0.007). Most frequent pathogens responsible for CLABSI were: Coagulase-negative staphylococci (CONS) (25.3%), Candida parapsilosis (21.8%), Pseudomonas aeruginosa (5.7), Escherichia coli and Klebsiella pneumoniae (6.8%). No microbiological diagnosis was achieved for 20.7% of CLABSI. Pseudomonas aeruginosa (28%), Stenotrophomonas maltophilia (20%), and CONS (20%) were the most frequent pathogens responsible for VAP. CLABSI incidence density showed no differences between 2006 and 2010 and 2013–2017, while VAP incidence density for the 751–100 g BW class was higher during 2006–2010 than during 2013–2017 (p = 0.006). A higher incidence of the CLABSI caused by Gram positive bacteria (p = 0.002) or by undetermined etiology (p = 0.01) was observed during 2013–2017 than during 2006–2010, while a significant lower incidence of VAP caused by Gram-negative bacteria was found during 2013–2017 than during 2006–2010 (p = 0.007). Conclusion: HAIs in the NICU developed in all BW classes with a decreasing trend from the lowest to the highest BW classes in both study periods. Differences in the aetiology of CLABSI and VAP were found between the two study periods. This reinforces the importance of HAIs surveillance protocol in the NICU, which monitors microbiological isolates and use of medical devices for all BW classes of neonates. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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