1053 EPIDEMIOLOGY OF NOSOCOMIAL INFECTIONS IN A NEWBORN INTENSIVE CARE UNIT

Abstract

Nosocomial infections (NI) are a known problem in newborn intensive care units (NBICU), but important predisposing factors are not clearly defined. Prospective surveillance for NI risk factors was conducted on all newborns admitted to the Utah NBICU longer than 48 hrs (at risk for NI) during a 6-month period. Twenty-five of 175 (14.3%) patients developed 52 NI, a NI rate of 29.7%. The most common first NI were pneumonia (13 or 52%) and necrotizing enterocolitis (7 or 28%). The 25 NI infants had a higher underlying disease severity score during the first 24 hrs after admission than the 150 non-NI babies (mean score of 5.4 vs 4.2 out of a scale of 8, p=.001). NI infants had a greater number of procedures than non-NI infants during the first week of hospitalization: 1) endotracheal tube days (mean of 5.6 vs 3.9, p=.007); 2) umbilical artery catheter (UAC) days (mean of 5.4 vs 3.8, p=.01); and 3) combined UAC and heel stick blood samples (mean of 125.5 vs 98.4, p=.008). The same significant associations were observed with the 13 NI pneumonia patients vs the non-NI infants. In addition, the 13 NI pneumonia cases had more endotracheal tube days than matched-control infants (mean of 5.7 vs 1.2, p=.03) during the 7 days prior to their first NI. These results indicate a significant association between underlying disease severity and the frequency of certain procedures and NI in NBICU infants.

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