Abstract
Nosocomial infections mainly are due to inefficient cleaning in association with the uncontrollable prescription of antimicrobials resulting in the emergence of multi-drug resistant pathogens in the hospital environment. Objectives:The study aims to evaluate the impact of the implementation of culture-guided antibiotic policy with strict infection control strategies on the occurrence of nosocomial infections and the resistance pattern ofthe isolated clinical and environmental pathogens. The study was done in 2 periods. Firstly, (August 2016 – April 2017), routine disinfection procedures and the applied antibiotic policy were evaluated. Secondly, according to the results a new antibiotic policy depending on the culture sensitivity results were implemented starting from June 2017 to February 2018 in association with strict infection control practices. As a result of this intervention, A change in the type of the isolated microorganisms was observed.Antibiotic resistance was decreased. Mortality rate was reduced from 14.1% to 9.5% of neonates with nosocomial infections, the number of the prescribed antibiotics didn’t exceed 4 antibiotics decreasing the overall cost for neonates’ therapy during their hospital stay. Each hospital should have its own antibiotic policy with the application of strict infection control strategies for the control of nosocomial infection.
Highlights
Nosocomial infection is one of the common complications in hospitalized patients and is considered as an important cause of morbidity and mortality among different cases in the intensive care units especially in neonatal intensive care units (NICUs)
Our study aims to study the prevalence of nosocomial infection, risk factors and the resistance pattern of the isolated strains from clinical and the environmental samples in NICU in Minia governorate, Egypt before and after using culture- based antibiotic policy with the application of the recommended infection control guidelines as recommended
A total of 1624 neonates were admitted to the neonatal intensive care unit (NICU) of Minia General Hospital
Summary
Nosocomial infection is one of the common complications in hospitalized patients and is considered as an important cause of morbidity and mortality among different cases in the intensive care units especially in neonatal intensive care units (NICUs). Neonatal hospitalacquired infections were found to be higher than that in the developed countries by 3 to 20 times These higher rates were attributed to the insufficient infection control measures (poor hand hygiene, insufficient number and distribution of washbasin, inadequate training of staff) applied during or after birth, crowded hospitals and limited resources resulting in acquiring neonatal sepsis, meningitis and pneumonia which may be fatal. Newborns (especially low birth weight and premature neonates) defense mechanisms are insufficient for their protection including their inefficient body structural barriers, absence of the protective endogenous normal flora and immaturity of immune system. All these factors make neonates at risk of acquiring infections during their exposure to various therapeutic interventions such as intubation, total parenteral nutrition, ventilation and using central venous and urinary catheters
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