Abstract
Background: Nosocomial infections are one of the main causes of neonatal morbidity and mortality in low- and middle-income countries. The neonatal intensive care unit is a suitable environment for disseminating infections. The aim of this study was to identify risk factors associated with having a nosocomial infection in the neonatal intensive care unit at Mahatma Gandhi Memorial hospital between 2014 and 2015.Methods: An observational, analytical case-control study was conducted at the neonatal intensive care unit at Mahatma Gandhi Memorial hospital in 2017 following ethical approval (BE336/16). A retrospective review of medical records for a sample size of 144 cases and 144 matched controls from 2014 to 2015 was analysed. Descriptive statistics were presented and multivariate conditional logistic regression was used to determine associations between the independent variables and having a nosocomial infection.Results: A total of 144 neonates developed nosocomial infections as proven by positive cultures with Klebsiella pneumoniae being most frequent (n = 60; 41.67%). On multivariate logistic regression analysis, multiple deliveries, low birth weight, respiratory distress, prematurity, neonatal jaundice, hyaline membrane disease, the use of total parenteral nutrition, blood transfusion and surfactant administration, immediate use of oxygen and intravenous fluid and central line insertion were significantly associated with having a nosocomial infection (p ≤ 0.001).Conclusion: Neonatal-related factors and treatment modalities were identified as factors that increased the risk for nosocomial infections. A review of treatment modalities and related infection prevention and control in neonatal management are the key to prevention, early detection and management of nosocomial infections.
Highlights
Neonates are a vulnerable group in the population, most prone to infections.[1]
More case mothers (n = 10; 6.94%) were Wasserman’s reaction (WR) positive compared with control mothers (n = 1; 0.69%), (p = 0.05) and (n = 12; 8.33%) were significantly more likely to have had multiple deliveries as compared with control mothers (n = 3; 2.08%) (p = 0.017)
In this study more case mothers were WR positive compared with control mothers (OR = 13.37; 95% CI 1.24–144.44); there are no identified studies that showed an association of nosocomial infection and WR
Summary
Neonates are a vulnerable group in the population, most prone to infections.[1]. Globally there were 7.6 million deaths in children aged below five years in 2010; 64% (4.9 million) were attributed to infectious causes and 40% (3.1 million) occurred in neonates.[2]. The aim of this study was to identify risk factors associated with having a nosocomial infection in the neonatal intensive care unit at Mahatma Gandhi Memorial hospital between 2014 and 2015. Methods: An observational, analytical case-control study was conducted at the neonatal intensive care unit at Mahatma Gandhi Memorial hospital in 2017 following ethical approval (BE336/16). On multivariate logistic regression analysis, multiple deliveries, low birth weight, respiratory distress, prematurity, neonatal jaundice, hyaline membrane disease, the use of total parenteral nutrition, blood transfusion and surfactant administration, immediate use of oxygen and intravenous fluid and central line insertion were significantly associated with having a nosocomial infection (p ≤ 0.001). Conclusion: Neonatal-related factors and treatment modalities were identified as factors that increased the risk for nosocomial infections. A review of treatment modalities and related infection prevention and control in neonatal management are the key to prevention, early detection and management of nosocomial infections
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