Epidemiologic trends in nosocomial bacteremia in a neonatal intensive care unit
Sung-Hsi Wei, Hsiu-Hui Chiu, Kuo-Chen Hung, Jen-Hsian Wang, Bai-Horng Su, Hung-Chih Lin, Tsung-Wen Lin, Hsiao-Chuan Lin
Department of Pediatrics and Section of Infectious Disease, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
Received: August 10, 2004 Revised: October 4, 2004 Accepted: December 4, 2004
The primary goal of this study was to analyze the epidemiologic features of nosocomial bloodstream infection (NBSI) in a neonatal intensive care unit over a 7-year period. All neonatal patients with NBSI treated from January 1997 to December 2003 were retrospectively analyzed. 232 NBSI episodes were diagnosed in 208 patients. The average NBSI patient-day rates were 4.69 and 2.59 per 1000 patient-days in 1997-1999 and 2000-2003, respectively. The average NBSI rates were 5.00 and 1.50 per 1000 patient days in neonates <1500 g and >1500 g, respectively. The proportion of Gram-positive organisms increased from 24% in 1997-2001 to 41% in 2002-2003, whereas the proportion of Gram-negative isolates decreased from 65% in 1997-2001 to 47% in 2002-2003. The implementation of measures for the prevention of nosocomial infection was associated with the reduction of NBSI rates. Low birth weight was demonstrated to be a significant risk factor for NBSI. The fact that Gram-positive organisms were isolated in increasing frequency may impact on the appropriate selection of empiric antimicrobial therapy for NBSI in the neonatal intensive care unit.
Bacteremia, cross infection, low birth weight infant, neonatal intensive care units, risk factors
J Microbiol Immunol Infect 2005;38:283-288.