Risk factors for hospital acquired bloodstream infections in neonatal intensive care unit of B.P. Koirala Institute of Health Sciences, Nepal

Abstract

Introduction: With the development of advanced technologies in neonatal intensive care worldwide, survival rates of newborns, particularly low birth weight and premature babies are higher. This has led to longer duration of hospital stay predisposing these babies to hospital-acquired infections (HAIs). Hence it is one of the main cause of morbidity and mortality in the neonatal intensive care unit (NICU). Objective: To determine the risk factors for HAI in NICU of B.P. Koirala Institute of Health Sciences (BPKIHS), Nepal Method: A prospective cohort study was conducted in a seven bedded teaching and referral NICU. All neonates in NICU who did not have any sign of infection at admission and remained hospitalized for at least 48 hours were observed. HAI was diagnosed according to the CDC criteria. Risk factors for HAI were analyzed with Chi-square test and Logistic regression model. A p-value of <0.05 was considered significant. Results: The incidence rate and density of HAI were 47% and 39.3 infections per 1000 patient-days respectively. Blood stream infection (BSI) was observed as the most common form of HAI (60.2%). Low birth weight and mechanical ventilation were found to be related to hospital acquired infection (p <0.05). Staphylococcus aureus was the most commonly isolated agent in haemocultures of patients with BSI. Conclusions: Low birth weight and mechanical ventilation were the most important risk factors for HAI in NICU of BPKIHS, Nepal.