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1.
J Perinatol ; 43(9): 1152-1157, 2023 09.
Article in English | MEDLINE | ID: mdl-37537269

ABSTRACT

OBJECTIVES: We studied the epidemiology of primary bloodstream infections (BSIs), secondary BSIs, and central line-associated BSIs (CLABSIs) and applicability of CDC definitions for primary sources of infection causing secondary BSIs in patients in the neonatal ICU. STUDY DESIGN: We classified healthcare-associated BSIs (HABSIs) as primary BSIs, secondary BSIs, and CLABSIs using CDC surveillance definitions and determined their overall incidence and incidence among different gestational age strata. We assessed the applicability of CDC definitions for infection sources causing secondary BSIs. RESULTS: From 2010 to 2019, 141 (32.7%), 202 (46.9%), and 88 (20.4%) HABSIs were classified as primary BSIs, secondary BSIs, and CLABSIs, respectively; all declined during the study period (all p < 0.001). Gestational age <28 weeks was associated with increased incidence of all HABSI types. CDC criteria for site-specific primary sources were met in 137/202 (68%) secondary BSIs. CONCLUSIONS: Primary and secondary BSIs were more common than CLABSIs and should be prioritized for prevention.


Subject(s)
Bacteremia , Catheter-Related Infections , Cross Infection , Sepsis , Infant, Newborn , Humans , Infant , United States/epidemiology , Intensive Care Units, Neonatal , Catheter-Related Infections/epidemiology , Bacteremia/diagnosis , Bacteremia/epidemiology , Bacteremia/etiology , Cross Infection/epidemiology , Sepsis/complications , Risk Factors , Delivery of Health Care , Centers for Disease Control and Prevention, U.S.
3.
J Pediatr ; 226: 294-298.e1, 2020 11.
Article in English | MEDLINE | ID: mdl-32621816

ABSTRACT

Neonatal intensive care unit graduates residing in high-risk neighborhoods were at increased risk of emergency department use and had higher rates of social/environmental risk factors. Distances to primary care provider and emergency department did not contribute to emergency department use. Knowledge of neighborhood risk is important for preventative service reform.


Subject(s)
Emergency Service, Hospital/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Intensive Care, Neonatal , Residence Characteristics/statistics & numerical data , Cohort Studies , Facilities and Services Utilization , Hospitalization , Humans , Infant , Infant, Newborn , Socioeconomic Factors
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