Nosocomial bloodstream infection and its risk factors in Razi Hospital’s Neonatal intensives care unit of Kermanshah (2002)

Background and objectives: NICU acquired infections are associated with increased mortality rates, prolonged duration of hospitalization in survivors and increased cost of neonatal health care. The frequency of these infections has increased in recent decades as a result of   increased survival of low birth weight infants. In this study,  incidence of nosocomial blood stream infection and risk factors were determined. 

Materials & methods: This analytic descriptive study was carried out in all newborns who admitted for minimum of 3 days in  NICU of Razi hospital of kermanshah in the year 1381. Routine blood culture was taken on admission, and in all newborns that had signs and symptoms of sepsis after 48 hours of admission. Nosocomial bloodstream infection was defined as first positive culture occurring > 48 h after admission , or another bacteria grown in the next blood culture. Demographic data,  and risk factors such as sex, weight  , gestational age, type of delivery, underlying disease and antibiotic sensitivity were collected by information sheet.   

Results:  Incidence of nosocomial bloodstream infection was 8/38 (CI : 5/5% to 11/25%).   The rate of infection was higher in very low birth weight infants.   There was no statistically  significant association between other risk factors (sex, gestational
age, type of delivery, underlying disease ) and rate of infection.  The isolated
microorganisms among 30 infected newborns include Enterobocter species (13 cases, 43/3%), klebsiella (10 cases, 33/3%), cytrobacter (6 cases, 20%) and  , satphylococcus aureus (1 case , 3/34%). The isolated microorganisms in all 29 newborns with  gram negative nosocomial blood stream infection showed resistance to routine NICU antibiotics (gentamycin, amikacin, and ceftizoxim).

Discussion :  Incidence of infection was the same as in other studies.   Very low birth weight newborns had more exposure to nosocomial bloodstream infection in comparison with other newborns.  There was  resistance to routine antibiotics.