The prevalence and diagnostic criteria of health-care associated infections in neonatal intensive care units in Turkey: A multicenter point- prevalence study
Makaleler > Tam Makale · 2021
Yazarlar: TUĞBA DEMİRDAĞ, ESİN KOÇ, HASAN TEZER, OĞUZ SUNA, MEHMET SATAR, ÖZGE SAĞLAM, SAİME SÜNDÜS UYGUN, ERAY ESRA ÖNAL, İBRAHİM MURAT HİRFANOĞLU, KADİR ŞERAFETTİN TEKGÜNDÜZ, NİHAL OYGÜR, ALİ BÜLBÜL, ADİL UMUT ZÜBARİOĞLU, NURAN ÜSTÜN, SEZİN ÜNAL, HASİBE CANAN AYGÜN, BELMA SAYGILI KARAGÖL, AYŞEGÜL ZENCİROĞLU, MEHMET YEKTA ÖNCEL, ADVİYE ÇAKIL SAĞLIK, EMEL OKULU, Demet TEREK, NEJAT NARLI, DİDEM ALİEFENDİOĞLU, TUĞBA GÜRSOY, SEVİM ÜNAL, MÜNEVVER KAYNAK TÜRKMEN, FATMA KAYA NARTER, NÜKHET ALADAĞ ÇİFTDEMİR, SERDAR BEKEN, SALİH ÇAĞRI ÇAKIR, ŞULE YİĞİT, EMİNE ASUMAN ÇOBAN, AYŞE NUR ECEVİT, YALÇIN ÇELİK, FERİT KULALI
Pediatrics & Neonatology, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Wos, 2021, cilt 62, ss 208-217
DOI: 10.1016/j.pedneo.2021.01.001
Özet
BACKGROUND: Healthcare-acquired infections (HAIs) in the neonatal period cause substantial morbidity, mortality, and healthcare costs. Our purpose was to determine the prevalence of HAIs, antimicrobial susceptibility of causative agents, and the adaptivity of the Centres for Disease Control and Prevention (CDC) criteria in neonatal HAI diagnosis. METHODS: A HAI point prevalence survey was conducted in the neonatal intensive care units (NICUs) of 31 hospitals from different geographic regions in Turkey. RESULTS: The Point HAI prevalence was 7.6%. Ventilator-associated pneumonia (VAP) and central line-associated bloodstream infections (CLABSI) and late onset sepsis were predominant. The point prevalence of VAP was 2.1%, and the point prevalence of CLABSI was 1.2% in our study. The most common causative agents in HAIs were Gram-negative rods (43.0%), and the most common agent was Klebsiella spp (24.6%); 81.2% of these species were extended spectrum beta-lactamase (ESBL) (+). Blood culture positivity was seen in 33.3% of samples taken from the umbilical venous catheter, whereas 0.9% of samples of peripherally inserted central catheters (PICCs) were positive. In our study, 60% of patients who had culture positivity in endotracheal aspirate or who had purulent endotracheal secretions did not have any daily FiO2 change (p = 0.67) and also 80% did not have any increase in positive end-expiratory pressure (PEEP) (p = 0.7). On the other hand, 18.1% of patients who had clinical deterioration compatible with VAP did not have endotracheal culture positivity (p = 0.005). CONCLUSIONS: Neonatal HAIs are frequent adverse events in district and regional hospitals. This at-risk population should be prioritized for HAI surveillance and prevention programs through improved infection prevention practices, and hand hygiene compliance should be conducted. CDC diagnostic criteria are not sufficient for NICUs. Future studies are warranted for the diagnosis of HAIs in NICUs.