Evaluation of 3 year surveillance of device associated infections in a neonatal intensive care unit

Abstract

Aim: The aim of this study was to determine the rates of healthcare associated infections (HAIs) and device associated healthcare associated infections (DA-HAIs) as well as the rates of invasive device utilization in a neonatal intensive care unit (NICU); and to compare findings with national and international reports.
 Materials and methods: A total of 1984 patients who admitted to NICU between January 2016 and December 2018 were enrolled. We retrospectively analysed patient’s characteristics, etiologic pathogens and antibiotic susceptibility, mortality from medical charts and infection control committee surveillance reports. Infections were defined using the standart Centers for Disease Control and Prevention criteria.
 Results: During the 3-year period, total 98 HAI cases 69 of which were DA-HAI were detected. The overall incidence of HAIs was 4.9% and rate was 3.7 per 1000 patient days. The most common HAI was blood stream infection (BSI) (n=64, 65.3%) of those 52 were central line-associated (CLA). The CLA-BSI rate was 8.6 per 1000 central line days with central line utilization ratio of 0.22. Ventilator associated pneumonia (VAP) rate was 5.1 per 1000 ventilator days with ventilator utilization ratio of 0.12. The most common pathogens were Klebsiella pneumonia. (38.9%), Staphylococcus epidermidis (22.1%) and Candida spp. (11.6%). The overall mortality rate was 3%. The HAI-related mortality rate was 9.2%.
 Conclusion: Our findings highlight the importance of an surveillance approach in the NICU setting. HAI rates were lower than the rates reported from developing countries. However, with device utilization rates similar to those in developed countries our HAI rates were higher than that of the developed countries. Continous monitoring and implementation of necessary precautions are essential to decrease the rates of HAIs.