Nosocomial infection investigation and risk factors in neonatal intensive care unit

Abstract

Objective To study the occurrence of nosocomial infection (NI)situation in the neonatal intensive care unit (NICU)of Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine from January 2012 to October 2013, and analyze risk factors of NI. Methods A retrospective study was performed in the NICU, of which all neonates hospitalized over 48 hours were included and the occurrence situation and risk factors of NI were analyzed. Results This study included 1 357 neonates, and 175 neonates developed 202 times NI.The overall incidence of NI was 14.89% (202/1 357), and the incidence density was 10.44 per 1 000 NICU patient-days (202/19 355). The lower the birth weight is, or the smaller gestational age is, the higher the NI rate is.The NI rate was 75.00% in neonates whose birth weight <1 000 g, and the NI rate was 52.63% in neonates whose gestational age <30 weeks.The most common infection type was pneumonia[43.07% (87/202)]and sepsis[26.73% (54/202)]. The hospital stay of the NI neonates was longer and the cost of hospitalization is higher than non-NI neonates (Median stay: 20 days and 10 days.Median cost: 21 045.32 yuan and 8 108.23 yuan)(both P<0.01). Univariate analysis showed there were significant differences between NI neonates and non-NI neonates on gestational age, birth weight, 5 min Apgar score, asphyxia rescue history, previons antibiotics use, mechanical ventilation, peripherelly inserted central catheter(PICC), closed thoracic drainage tube and chest or abdominal surgery before NI.The logistic regression analysis indicated that previous antibiotics use, mechanical ventilation and PICC were important risk factors for NI. Conclusion The NI rate in NICU is still high.Previous antibiotics use, mechanical ventilation and central venous catheter are risk factors of NI. Key words: Neonatal intensive care unit; Neonate; Nosocomial infection; Risk factor