Device-associated infections among neonatal intensive care unit patients: incidence and associated pathogens reported to the National Healthcare Safety Network, 2006-2008
| Autor: | Fernanda C. Lessa, Jonathan R. Edwards, Teresa C. Horan, Gloria C. Morrell, Martha Iwamoto, Susan N. Hocevar |
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| Rok vydání: | 2012 |
| Předmět: |
Microbiology (medical)
Methicillin-Resistant Staphylococcus aureus Pediatrics medicine.medical_specialty Catheterization Central Venous Umbilical Veins Neonatal intensive care unit Epidemiology Birth weight Bacteremia medicine.disease_cause Hospitals General symbols.namesake Catheters Indwelling Intensive care Health care medicine Birth Weight Humans Pseudomonas Infections Poisson regression Ventilators Mechanical business.industry Incidence (epidemiology) Incidence Candidiasis Infant Newborn Pneumonia Ventilator-Associated Staphylococcal Infections medicine.disease Hospitals Pediatric Methicillin-resistant Staphylococcus aureus United States Klebsiella Infections Pneumonia Infectious Diseases Catheter-Related Infections symbols Intensive Care Neonatal business Fungemia |
| Zdroj: | Infection control and hospital epidemiology. 33(12) |
| ISSN: | 1559-6834 0195-9417 |
| Popis: | Objective.To describe rates and pathogen distribution of device-associated infections (DAIs) in neonatal intensive care unit (NICU) patients and compare differences in infection rates by hospital type (children's vs general hospitals).Patients and Setting.Neonates in NICUs participating in the National Healthcare Safety Network from 2006 through 2008.Methods.We analyzed central line–associated bloodstream infections (CLABSIs), umbilical catheter–associated bloodstream infections (UCABs), and ventilator-associated pneumonia (VAP) among 304 NICUs. Differences in pooled mean incidence rates were examined using Poisson regression; nonparametric tests for comparing medians and rate distributions were used.Results.Pooled mean incidence rates by birth weight category (750 g or less, 751–1,000 g, 1,001–1,500 g, 1,501–2,500 g, and more than 2,500 g, respectively) were 3.94, 3.09, 2.25, 1.90, and 1.60 for CLABSI; 4.52, 2.77, 1.70, 0.91, and 0.92 for UCAB; and 2.36, 2.08, 1.28, 0.86, and 0.72 for VAP. When rates of infection between hospital types were compared, only pooled mean VAP rates were significantly lower in children's hospitals than in general hospitals among neonates weighing 1,000 g or less; no significant differences in medians or rate distributions were noted. Pathogen frequencies were coagulase-negative staphylococci (28%),Staphylococcus aureus(19%), andCandidaspecies (13%) for bloodstream infections andPseudomonasspecies (16%),S. aureus(15%), andKlebsiellaspecies (14%) for VAP. Of 673S. aureusisolates with susceptibility results, 33% were methicillin resistant.Conclusions.Neonates weighing 750 g or less had the highest DAI incidence. With the exception of VAP, pooled mean NICU incidence rates did not differ between children's and general hospitals. Pathogens associated with these infections can pose treatment challenges; continued efforts at prevention need to be applied to all NICU settings. |
| Databáze: | OpenAIRE |
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