Neonatal nosocomial infection: profile and risk factors.

ABSTRACT

PIP: The incidence and risk factors for neonatal nosocomial infection were investigated in a cohort study of 134 hospital-born infants transferred to a neonatal unit in New Delhi, India, after birth and observed for up to 72 hours. 22 of the 134 infants developed nosocomial infections. The median age at diagnosis was 184 hours. In 16 of these infants, both sepsis screen and blood culture were positive. Septicemia was diagnosed in 21 neonates; 11 had associated pneumonia and four had soft tissue infection. Multiresistant Klebsiella species was the infectious agent in 68% of cases. The overall nosocomial infection rate was 16.8/1000 patient-days and the device-associated infection rate was 11.9/1000 device-days. Factors significantly associated with neonatal nosocomial infection in the univariate analysis were low birth weight, prematurity, vaginal delivery, hyaline membrane disease, assisted ventilation, and use of peripheral venous and umbilical vascular catheters. In the final multivariate analysis, only birth weight under 1500 g (odds ratio, 3.3) and assisted ventilation for more than 72 hours (odds ratio, 14.2) remained significant risk factors. It was observed in 122 random observations in this hospital that 15-18% of nurses and residents failed to adhere to adequate hand-washing techniques. Strict adherence to aseptic protocols in neonatal units is essential to keep infection rates under control.