The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence study.

Autor:	Bedir Demirdağ T; Gazi University, Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara, Turkey. Electronic address: tugbabedir@gmail.com., Koç E; Gazi University, Faculty of Medicine, Department of Neonatology, Ankara, Turkey., Tezer H; Gazi University, Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara, Turkey., Oğuz S; University of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Department of Neonatology, Ankara, Turkey., Satar M; Çukurova University, Faculty of Medicine, Department of Neonatology, Adana, Turkey., Sağlam Ö; University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Department of Neonatology, Istanbul, Turkey., Uygun SS; Konya Selcuk University, Faculty of Medicine, Department of Neonatology, Konya, Turkey., Önal E; Gazi University, Faculty of Medicine, Department of Neonatology, Ankara, Turkey., Hirfanoğlu İM; Gazi University, Faculty of Medicine, Department of Neonatology, Ankara, Turkey., Tekgündüz K; Atatürk University, Faculty of Medicine, Department of Neonatology, Erzurum, Turkey., Oygür N; Akdeniz University, Faculty of Medicine, Department of Neonatology, Antalya, Turkey., Bülbül A; University of Health Sciences, Sisli Etfal Training and Research Hospital, Department of Neonatology, Istanbul, Turkey., Zübarioğlu AU; Yeni Yüzyıl University Faculty of Medicine, Department of Neonatology, Istanbul, Turkey., Üstün N; Medeniyet University. Goztepe Training and Research Hospital, Department of Neonatology, Istanbul, Turkey., Ünal S; University of Health Sciences, Etlik Zübeyde Hanim Women's Health Training and Research Hospital, Department of Neonatology, Ankara, Turkey., Aygün C; Ondokuz Mayıs University, Faculty of Medicine, Department of Neonatology, Turkey., Saygılı Karagöl B; University of Health Sciences, Gülhane Training and Research Hospital, Department of Neonatology, Ankara, Turkey., Zenciroğlu A; University of Health Sciences, Dr. Sami Ulus Maternity and Children Education and Research Hospital, Department of Neonatology, Ankara, Turkey., Öncel MY; University of Health Sciences Izmir Tepecik Training and Research Hospital, Department of Neonatology, Izmir, Turkey., Çakıl Sağlık A; Osmangazi University, Faculty of Medicine, Department of Neonatology, Eskisehir, Turkey., Okulu E; Ankara University, Faculty of Medicine, Department of Neonatology, Ankara, Turkey., Terek D; Ege University, Faculty of Medicine, Department of Neonatology, Izmir, Turkey., Narlı N; Metro Private Hospital, Neonatology Unit, Adana, Turkey., Aliefendioğlu D; Kırıkkale University, Faculty of Medicine, Department of Neonatology, Kırıkkale, Turkey., Gürsoy T; Koc University, Faculty of Medicine, Department of Neonatology, Istanbul, Turkey., Ünal S; University of Health Sciences, Ankara Hematology Oncology Children's Training and Research Hospital, Department of Neonatology, Ankara, Turkey., Kaynak Türkmen M; Adnan Menderes University, Faculty of Medicine, Department of Neonatology, Aydın, Turkey., Kaya Narter F; University of Health Sciences, Kartal Dr Lutfi Kirdar Training and Research Hospital, Department of Neonatology, Istanbul, Turkey., Aladağ Çiftdemir N; Trakya University, Faculty of Medicine, Department of Neonatology, Edirne, Turkey., Beken S; Acıbadem University, Faculty of Medicine, Department of Neonatology, Istanbul, Turkey., Çakır SÇ; Uludağ University, Faculty of Medicine, Department of Neonatology, Bursa, Turkey., Yiğit Ş; Hacettepe University, Faculty of Medicine, Department of Neonatology, Ankara, Turkey., Çoban A; Istanbul University, Faculty of Medicine, Department of Neonatology, Istanbul, Turkey., Ecevit A; Baskent University, Faculty of Medicine, Department of Neonatology, Ankara, Turkey., Çelik Y; Mersin University, Faculty of Medicine, Department of Neonatology, Mersin, Turkey., Kulalı F; University of Health Sciences, Dr. Behcet Uz Children's Health and Diseases and Surgery Training and Research Hospital, Department of Neonatology, Izmir, Turkey.
Jazyk:	angličtina
Zdroj:	Pediatrics and neonatology [Pediatr Neonatol] 2021 Mar; Vol. 62 (2), pp. 208-217. Date of Electronic Publication: 2021 Jan 19.
DOI:	10.1016/j.pedneo.2021.01.001
Abstrakt:	Background: Healthcare-acquired infections (HAIs) in the neonatal period cause substantial morbidity, mortality, and healthcare costs. Our purpose was to determine the prevalence of HAIs, antimicrobial susceptibility of causative agents, and the adaptivity of the Centres for Disease Control and Prevention (CDC) criteria in neonatal HAI diagnosis. Methods: A HAI point prevalence survey was conducted in the neonatal intensive care units (NICUs) of 31 hospitals from different geographic regions in Turkey. Results: The Point HAI prevalence was 7.6%. Ventilator-associated pneumonia (VAP) and central line-associated bloodstream infections (CLABSI) and late onset sepsis were predominant. The point prevalence of VAP was 2.1%, and the point prevalence of CLABSI was 1.2% in our study. The most common causative agents in HAIs were Gram-negative rods (43.0%), and the most common agent was Klebsiella spp (24.6%); 81.2% of these species were extended spectrum beta-lactamase (ESBL) (+). Blood culture positivity was seen in 33.3% of samples taken from the umbilical venous catheter, whereas 0.9% of samples of peripherally inserted central catheters (PICCs) were positive. In our study, 60% of patients who had culture positivity in endotracheal aspirate or who had purulent endotracheal secretions did not have any daily FiO2 change (p = 0.67) and also 80% did not have any increase in positive end-expiratory pressure (PEEP) (p = 0.7). On the other hand, 18.1% of patients who had clinical deterioration compatible with VAP did not have endotracheal culture positivity (p = 0.005). Conclusions: Neonatal HAIs are frequent adverse events in district and regional hospitals. This at-risk population should be prioritized for HAI surveillance and prevention programs through improved infection prevention practices, and hand hygiene compliance should be conducted. CDC diagnostic criteria are not sufficient for NICUs. Future studies are warranted for the diagnosis of HAIs in NICUs. Competing Interests: Declaration of competing interest We declare that there are no competing financial interests in relation to the work described. (Copyright © 2021. Published by Elsevier B.V.)
Databáze:	MEDLINE
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