Clinico-microbiological profile of healthcare associated infections in a neonatal intensive care unit and its relation with environmental surveillance

Abstract

Healthcare associated infections (HAI’s) or nosocomial infections are frequently encountered in neonatal intensive care units (NICU’s), resulting in morbidity as well as mortality of new born babies, with varying predisposing factors and microbiological profile. This study was conducted to identify the most common HAI among the neonates admitted in the NICU, to identify the risk factors of HAI’s in neonates and to compare the bacteriological profile of culture positive cases with the results of environmental survey. This was a prospective study, conducted for a duration of one and a half years from December 2018 to May 2020. Environmental samples from the NICU as well as clinical samples from neonates admitted to the NICU of a tertiary care centre for a duration of more than 2 calendar days were collected. The most common HAI in the NICU was VAP (41.6%), followed by CLABSI (21.8%). Statistically significant risk factors for neonatal nosocomial infection were preterm birth, LSCS, presence of comorbidities, Low Birth Weight, absence of breast feeding and Apgar score. The most common Gram negative organism isolated was Acinetobacter baumannii (18.8%) and Gram positive organism as Methicillin Resistant Coagulase negative Staphylococcus (MRCoNS) (13.9%).Acinetobacter baumanni above average isolation rate was matching with the growth of the similar organism each month, according to the surveillance report. The most common HAI among neonates in our study was VAP, majority of which were caused by Gram negative bacteria. Acinetobacter baumanni was found to have an isolation rate above average on environmental surveillance, indicating its role in causing HAI’s in neonates admitted to the NICU. However, this study did not show a definitive association between HAI and the environmental surveillance report.