Risk Factors for Nosocomial Infection in a Neonatal Intensive Care Unit

2006 ◽  
Vol 27 (6) ◽  
pp. 571-575 ◽  
Author(s):  
Renato C. Couto ◽  
Tania M. G. Pedrosa ◽  
Cristina de Paula Tofani ◽  
Enio R. P. Pedroso

Objective.To determine risk factors for nosocomial infection in a neonatal intensive care unit (NICU).Design.A prospective, open cohort study.Setting.A 22-bed NICU.Patients.Neonates admitted to a single NICU during 1994-1998 were included in the study. Outcome variables included central venous catheter (CVC)–associated primary bloodstream infection (BSI), non–CVC-associated primary BSI, pneumonia, and overall nosocomial infection. Independent variables included birth weight, use of mechanical ventilation (MV), duration of MV, use of a CVC, duration of CVC use, duration of NICU stay, gestational age, congenital malformation, maximum (ie, worst) base excess, and maximum and minimum fraction of inspired oxygen (FIO2) for maintaining appropriate blood saturation levels during the first 12 hours after NICU admission.Results.A total of 1051 neonates were admitted to the NICU. Overall, 358 NIs were diagnosed. Non–CVC-associated primary BSI was the most frequent nosocomial infection (in 195 neonates [54.5%]), followed by pneumonia (46 [12.8%]), and CVC-associated primary BSI (35 [9.8%]). The mortality rate was 16%. In the final logistic regression model, the following 5 risk factors were found to be predictive of nosocomial infection development: use of MV, longer duration of MV, longer duration of CVC use, longer duration of NICU stay, and low maximum appropriate FIO2.Conclusion.Invasive device use and duration of use continue to greatly influence the development of nosocomial infection in NICUs. In our cohort, birth weight showed no influence on the development of nosocomial infection. Low maximum FIO2 influenced the occurrence of overall nosocomial infection.

Perinatology ◽  
2019 ◽  
Vol 30 (2) ◽  
pp. 60 ◽  
Author(s):  
Young Duck Kim ◽  
Na Mi Lee ◽  
Su Yeong Kim ◽  
Dae Yong Yi ◽  
Sin Weon Yun ◽  
...  

2019 ◽  
Vol 11 (1) ◽  
pp. 17-21
Author(s):  
Asma Helyaich ◽  
Nadia El Idrissi Slitine ◽  
Fatiha Bennaoui ◽  
abdelmounaim Aboussad ◽  
Nabila Soraa ◽  
...  

Background and AimNosocomial infections are one of the major causes of morbidity in the Neonatal Intensive Care Unit (NICU). Known risk factors include birth weight, gestational age, severity of illness and its related length of stay, and instrumentation.Objective:The purpose of this article is to determine the occurrence of Nosocomial Infections (NIs), including infection rates, main infection sites, and common microorganisms.Methods:A retrospective study was conducted between June 2015 and December 2016.Results:The incidence of nosocomial infection was 16%. The primary reasons for admission were intauterin growth retardation (52.5%).Klebsiella Pneumoniaewas the most commonly identified agent in the blood cultures and in the hospital unit (43.6%). The mortality rate from nosocomial infection was 52.6%. The proportion of infected newborns with a lower than normal birth weight was predominant (58.13%).Conclusion:Thus, prevention of bacterial infection is crucial in these settings of unique patients. In this view, improving neonatal management is a key step, and this includes promotion of breast-feeding and hygiene measures.


Author(s):  
Margaret Jaraiseh Abcarius ◽  
Berly Alejandra Zambrano Bravo ◽  
Manuel Eugenio Morocho-Cayamcela ◽  
Ana Belén Tulcanaza-Prieto

Introducción: El peso al nacer es uno de los principales indicadores pronóstico de mortalidad neonatal, en el que influyen factores asociados con la madre, el neonato, y también con las características socioeconómicas del núcleo familiar. Los factores de riesgo implican comorbilidades al momento del nacimiento, por lo que, la intervención adecuada y el oportuno acceso a los servicios de salud constituyen elementos primordiales para la reducción de la mortalidad neonatal. Objetivo: establecer los factores de riesgo asociados a la mortalidad y peso al nacer de pacientes neonatos, de la Unidad de Cuidados Intensivos Neonatales del Hospital Pediátrico Baca Ortiz. Métodos: Se realizó una investigación de diseño observacional, transversal de tipo descriptivo que con una muestra de 204 recién nacidos ingresados en la Unidad de Cuidados Intensivos Neonatales del Hospital Pediátrico Baca Ortiz en la ciudad de Quito, Ecuador, durante el año 2019.  Resultados: El peso al nacimiento tiene una asociación lineal negativa significativa con la mortalidad neonatal, siendo los neonatos de género masculino los más susceptibles a fallecer. También, existe mayor frecuencia de mortalidad neonatal en las madres que residen en el área urbana de la sierra ecuatoriana. Conclusiones: El peso al nacer es una variable de gran influencia en la salud y supervivencia infantil, debido a que los datos epidemiológicos muestran que un niño que nace con un peso por debajo de los límites normales tiene un mayor riesgo de fallecer, en comparación con los niños nacidos con un peso dentro del rango considerado normal.   Palabras clave: Mortalidad infantil, factores de riesgo, recién nacido de bajo peso, enfermería neonatal, mortalidad neonatal.  Abstract Introduction: Birth weight is one of the main prognostic indicators of neonatal mortality, which is influenced by factors associated with the mother, the neonate, and the socioeconomic characteristics of the family. Moreover, the risk factors imply comorbidities at birth. Therefore, adequate intervention and timely access to health services constitute essential elements to reduce neonatal mortality. Objective: establish the risk factors associated with mortality and birth weight of neonatal patients, from the Neonatal Intensive Care Unit of the Baca Ortiz Pediatric Hospital. Methods: An observational, cross-sectional, descriptive research was carried out with a sample of 204 newborns admitted to the Neonatal Intensive Care Unit of the Baca Ortiz Pediatric Hospital in the city of Quito, Ecuador, during the year 2019. Results: The birth weight shows a significant negative linear association with neonatal mortality, where the male infants are the most susceptible to death. Furthermore, there is a higher frequency of neonatal mortality in mothers who live in the urban area of ​​the Ecuadorian highlands. Conclusions: The birth weight is a highly influential variable for child health and survival since epidemiological data show that a newborn with a weight below the range considered normal, has a higher risk of death as compared to children with a normal weight. Keywords: Infant mortality, risk factors, low birth weight, neonatal nursing, neonatal mortality.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Ksheeraja Sriram ◽  
Amna Umer ◽  
Candice Hamilton ◽  
Collin C John ◽  
Christa LILLY

Background: Neonatal intensive care unit (NICU) admission is often due to specific cardiovascular conditions. Low birthweight, another common reason for NICU admission, is also linked to later cardiovascular risk. Within the past decade, the rate of NICU admissions in the United States has significantly increased. Identification of emerging risk factors for NICU admission will help inform efforts to reduce the number of newborns requiring intensive care. Methods: The objective of this study was to identify risk factors for NICU admission in all infants born in West Virginia (WV), 2012-2017, via Project WATCH. Fifteen exposure variables including demographics, maternal and infant characteristics, were included in multivariable logistic regression analyses, stratified by preterm and term births. Results: Of 120,894 neonates, 6,393 (5.3%) were admitted to NICU. Among preterm infants (Table 1), predictors included male sex (OR: 1.11), insurance status (OR: 1.29), APGAR scores less than or equal to 3 (OR: 2.57), maternal diabetes (OR: 1.68 and 2.01), residence outside WV (OR: 1.27), intrauterine substance exposure (OR: 1.94), congenital abnormalities (OR: 2.58), and low birthweight (OR: 1.73 and 6.64). Risk factors in term infants included all factors identified for preterm infants, as well as maternal smoking, maternal age, and number of previous pregnancies. Conclusions: In addition to infant characteristics predictive of NICU admission (e.g., birthweight and APGAR score), socioeconomic factors (e.g., insurance status and rurality) and preventable risk factors (e.g., maternal smoking and substance use) provide an opportunity for intervention during pregnancy, with the goal to decrease the number of newborns requiring intensive care.


2017 ◽  
Vol 102 (8) ◽  
pp. 3050-3055 ◽  
Author(s):  
Amnon Zung ◽  
Rachel Bier Palmon ◽  
Agneta Golan ◽  
Mara Troitzky ◽  
Smadar Eventov-Friedman ◽  
...  

Abstract Context Delayed thyrotropin (TSH) elevation (dTSH) is defined as elevated TSH at the second neonatal screening (after normal TSH levels at the initial screening) in premature, low-birth-weight, and ill newborns, mostly in the neonatal intensive care unit (NICU) setting. The pathogenesis of dTSH is elusive. Objective To identify the risk factors for dTSH development among newborns in the NICU. Design, Setting, and Patients A retrospective medical record review of neonates with dTSH was conducted in eight university-affiliated NICUs. Two controls were selected for each patient, matched for sex and birth weight. The risk factors for dTSH were identified by univariate analysis, followed by multivariate analysis. Main Outcome Measures Maternal variables, types of NICU treatments and procedures, syndromes, and various medical conditions were compared between dTSH patients and their matched controls. Results We enrolled 100 dTSH patients and 200 matched controls and 46 variables were compared between the two groups. Twelve risk factors for dTSH were identified on univariate analysis: cesarean section, mechanical ventilation, patent ductus arteriosus (PDA), pneumothorax, and administration of cefotaxime, vancomycin, fluconazole, dopamine, ibuprofen, furosemide, insulin, and packed red blood cells. On multivariate analysis, four risk factors were identified: PDA and vancomycin, insulin, and furosemide administration. In 26 twin pairs, in which one twin had dTSH, all variables presented similarly in both twins. Conclusions Although some variables had direct effects on pituitary–thyroid axis dysfunction, these variables, altogether, reflect the severity of the clinical conditions in the NICU, which is the common basis for dTSH.


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