A 4-year surveillance of Device-Associated nosocomial infections in a neonatal intensive care unit

Tekin R., Dal T., Pirinccioglu H., Oygucu S. E.

Pediatrics and Neonatology, vol.54, no.5, pp.303-308, 2013 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 54 Issue: 5
  • Publication Date: 2013
  • Doi Number: 10.1016/j.pedneo.2013.03.011
  • Journal Name: Pediatrics and Neonatology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.303-308
  • Keywords: Device-associated health care-associated infection, Neonatal intensive care unit, Nosocomial infection, Ventilator-associated pneumonia
  • Ankara Yıldırım Beyazıt University Affiliated: Yes


Background: The aim of this study was to determine the rate of health care-associated infection (HC-AI) and device-associated health care-associated infections (DA-HAIs), and distribution of causative microorganisms and etiologic factors responsible for these infections in a neonatal intensive care unit (NICU) of a state hospital in southeastern Turkey. Methods: A laboratory-based, active, prospective nosocomial infection surveillance study was performed in NICUs from January 2008 to December 2011. The rates of HC-AIs were determined on a daily basis. The findings were evaluated by applying the definitions of the Centers for Disease Control and Prevention National Healthcare Safety Network. Results: In a 4-year period, 580 HC-AIs, 81 of which were DA-HAIs, were detected among 6932 patients. The rate of hospital acquired infection was 8.3% and 7.69/1000 patient days. Ventilator-associated pneumonia (VAP) was the second most frequent (13.1%) HC-AI and the most frequent was DA-HAI. The VAP rate was 6.4 per 1000 ventilator days. Mechanical ventilation was the most frequently used invasive device. Median time to diagnosis of VAP was 32.11 ± 29.3 days from the time of admission. Acinetobacter baumannii (48%) and Pseudomonas aeruginosa (32%) were the most frequent microorganisms. Colistin was the most effective antibiotic by in vitro test. The antibiotic resistance ratios of A. baumannii were ≥54% for carbapenems, aminoglycosides, and cefoperazone-sulbactam; ≥88% for quinolones; and ≥92% for ceftazidime, ceftriaxone, and piperacillin-tazobactam. Conclusions: Device-associated nosocomial infections was a particularly important problem in NICU. Close monitoring will decrease the rates of device-related nosocomial infections. Copyright © 2013, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved.