Nosocomial infections in neonatal intensive care unit

Abstract

Introduction: Nosocomial infections are one of the important mortality and morbidity reasons among newborns. For this reason recognition of infection factors and the resistance to antimicrobials in intensive care unit is very important in terms of rational antibiotic use. Materials and Methods: Nosocomial infections seen in our neonatal intensive care unit between 2009 and 2011 were retrospectively analyzed. Isolated strains, antibiotic sensitivities, the use of invasive tool, infectious species and infection rates were determined according to the data provided by National Nosocomial Infections Surveillance Control Unit. Results: A total of 4258 patients were observed for 34625 patient days, 6536 ventilator days, 98 urinary catheter days, 601 central venous catheter days and 590 umbilical catheter days. The infection rate was 3.26% (139/4258) and the incident density was 4.01‰. Pneumonia was on the frst rank (61; 43%) and it was in ventilator association form. 36 strains were isolated as the infectious agents. The rates of gram negative factors was 23 (63.88%), gram positive factors was 8 (22.22%) and Candida spp. was 5 (13.88 %). The most frequently isolated gram negative strains were Klebsiella spp. (7; 19.4%) and Pseudomonas spp. (7; 19.4 %). The most effective antibiotics in Enterobactericeae spp. were meropenem and imipenem. In enteric gram negative rods, extended spectrum beta lactamase positivity was 63.64%. In the neonatal intensive care unit, ventilator associated pneumonia rate was 6.73% and the ventilator use ratio was 19%. Conclusions: In conclusion, each intensive care unit should determne the factors and follow antimicrobial resistant patterns. Empiric antibiotic treatment strategy should be established. Decreasing or totally preventing hospital infections would be possible by active surveillance system, adoption infection control guidelines, limitation of instrument use and rational antibiotic use rules