Nosocomial Infection Surveillance in a Colombian Neonatal Intensive Care Unit

BACKGROUND/OBJECTIVES: Nosocomial Infections are a major problem at the Neonatal Intensive Care Unit (NICU) in developing countries. Surveillance is considered one the most important measures to control and reduce the rates of infections on the hospital settings. The objective of this study was to describe the epidemiology of Nosocomial Infections in the NICU at the Hospital San Pedro Claver in Bogotá – Colombia. METHODS: A prospective Nosocomial Infection Surveillance was performed in the NICU during 10 months; from February through November 2005. Centers for Disease Control and Prevention criteria were used as standard definitions for Nosocomial Infection. Birth weight was stratified into four categories. Patient days, device days and device utilization rates were calculated with NNIS (National Nosocomial Infections Surveillance) methods for each of 4 birth-weight categories. These rates were compared with the high-risk nursery surveillance component of the annual report of the NNIS of October 2004. RESULTS: 141 neonates were included during the surveillance. Thirty six neonates developed 39 infections. The accumulative rate of Nosocomial Infection was 1.3 per 100 patients at risk. Bacteremia (56.4%), clinical sepsis (17.9%) pneumonia (17.9%), necrotizing enterocolitis (5.1%) and meningitis (2.5%) were the most common infections. Gram-positive bacteria were the most commonly isolated germs (77%), with coagulase-negative Staphylococcus (50%) being the main pathogen. Results for device utilization and device-associated infections are shown in Table 1. Table 1 BSI = Bloodstream infection.¶ Centile position of our unit. CONCLUSIONS: Device utilization and device-associated Nosocomial infection rates in our institution are higher compared with those of NICUs participating in the NNIS. For this reason, the use of appropriate infection control measures will be a successful strategy to reduce the infection rates.