[Nosocomial infections in a neonatal unit: surveillance program]. / Infecciones nosocomiales en una Unidad de Cuidados Neonatales: programa de vigilancia epidemiológica.

INTRODUCTION: Nosocomial infections in neonatal units are frequent and require having a surveillance program which allows detection and implementation of preventive strategies. OBJECTIVE: To determine the incidence and distribution of hospital infections and the rate of use of devices in a neonatal unit compared with international standards. METHODS: Epidemiological, observational, analytical, prospective cohort study. We developed and carried out a monitoring program, stratifying infants by birth weight, recording the use of central catheters, mechanical ventilation, parenteral nutrition and bladder catheter. We calculated the total patient days, the device utilization rates and episodes of hospital infection. The data were compared with those of the National Nosocomial Infection Surveillance. RESULTS: 1530 infants were admitted to the Neonatal Care Unit from 01/01/2006 to 31/12/2008 totaling 22 237 days patients. We identified 138 episodes of hospital infections, adjusted overall rate 6.23 episodes per 1000 patient/days. Overall rates of devices' use were: central catheter 32.3%, mechanical ventilation 14.2%, bladder catheter 4.6%. The overall rate of nosocomial infection associated with central catheter was 8.6 ‰. All groups had rates within the published rates, except the group of infants <1000 grams (19.7 ‰), that exceeded the 90th percentile. With regard to ventilator associated pneumonia (overall rate 1.9‰), rates were comparable. CONCLUSION: The description of the occurrence and distribution of nosocomial infections and their association with risk factors could be determined and generally showed to be found within the published percentiles.