SURVEILLANCE OF HOSPITAL ACQUIRED BLOODSTREAM INFECTIONS IN NEONATAL INTENSIVE CARE UNIT

BACKGROUND: Hospital acquired bloodstream infections (BSI) are important cause of morbidity and mortality in Neonatal Intensive Care Unit (NICU) as well as of prolonged hospitalization and additional costs. AIM: The present study was performed to determine the incidence rate and incidence density of hospital acquired BSI in NICU along with their microbiological profile and sensitivity pattern. SETTINGS AND DESIGN: The study was conducted prospectively from 1st May 2009 to 30th June 2010, in the NICU at a tertiary care hospital in Gujarat. METHODS AND MATERIAL: Hospital acquired BSIs were identified according to National Nosocomial Infection Surveillance System (NNIS) definition. The incidence rate was calculated as BSIs per 100 admissions, and incidence density was calculated as BSIs per 1000 patient-days and 1000 central line-days. RESULTS: During the study period 626 neonates were admitted in NICU out of which 40 neonates were positive for hospital acquired BSI with incidence rate of 6.38 per 100 admissions and incidence density of 22.64 per 1000 patient-days. Central line-associated BSI (CLABSI) rate was 57.14 per 1000 central line-days. Klebsiella pneumoniae (67.5%) was the predominant isolate with all strains being ESBL producers. CONCLUSIONS: Hospital acquired BSIs in NICU was identified as a significant problem reflecting a need for strict implementation of preventive measures. Inadequate staffing has also been observed in the present study as a predisposing factor to the nosocomial BSIs.