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Healthcare-Associated Infections Among Neonates in Brazil

Published online by Cambridge University Press:  02 January 2015

Carmem Lúcia Pessoa-Silva ,
Rosana Richtmann ,
Roseli Calil ,
Rosana Maria Rangel Santos ,
Maria Luiza M. Costa ,
Ana Cristina Cisne Frota  and
Sergio Barsanti Wey
Carmem Lúcia Pessoa-Silva*
Affiliation:
Universidade Federal do Rio de Janeiro, Rio de JaneiroBrazil
Rosana Richtmann
Affiliation:
Hospital e Maternidade Santa Joana, São PauloBrazil
Roseli Calil
Affiliation:
UNICAMP/Universidade Estadual de Campinas, São Paulo, Brazil
Rosana Maria Rangel Santos
Affiliation:
Universidade Federal do Rio de Janeiro, Rio de JaneiroBrazil
Maria Luiza M. Costa
Affiliation:
Hospital e Maternidade Santa Joana, São PauloBrazil
Ana Cristina Cisne Frota
Affiliation:
Universidade Federal do Rio de Janeiro, Rio de JaneiroBrazil
Sergio Barsanti Wey
Affiliation:
Universidade Federal de São Paulo, São Paulo, Brazil
*
Service Prévention et Controle de l'Infection – UPCI, Hôpitaux Universitaires de Genève, 24, rue Micheli du Crest - CH-1211, Geneva 14, Switzerland
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Abstract

Objective:

To describe the epidemiology of healthcare-associated infections (HAIs) among neonates.

Design:

Prospective surveillance of HAIs was conducted during 2 years. Infections beginning within 48 hours of birth were defined as HAIs of maternal origin. Death occurring during an active episode of HAI was considered related to HAI.

Setting:

Seven neonatal units located in three Brazilian cities.

Patients:

All admitted neonates were included and observed until discharge.

Results:

Twenty-two percent of 4,878 neonates had at least one HAI. The overall incidence density was 24.9 per 1,000 patient-days, and 28.1% of all HAIs were maternally acquired. HAI rates ranged from 12.3% in the group with a birth weight (BW) of more than 2,500 g to 51.9% in the group with a BW of 1,000 g or less. The main HAIs were bloodstream infection (BSI) and pneumonia. Coagulase-negative staphylococci, Enterobacter species, Staphylococcus aureus, and Klebsiella pneumoniae were the main pathogens. Forty percent of all deaths were related to HAI. Central venous catheter (CVC)-associated BSIs per 1,000 CVC-days ranged from 17.3 (BW, 1,501 to 2,500 g; device utilization [DU], 0.11) to 34.9 (BW, ≤ 1,000 g; DU, 34.92). Ventilator-associated pneumonia per 1,000 ventilator-days ranged from 7.0 (BW, ≤ 1,000 g; DU, 0.34) to 9.2 (BW, 1,001 to 1,500 g; DU, 0.14).

Conclusions:

The high proportion of HAIs of maternal origin highlights perinatal care issues in Brazil and the need to improve the diagnosis of neonatal HAIs. The very low BW group and device-associated infections should be priorities for prevention strategies in this population.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 9 , September 2004 , pp. 772 - 777
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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