Efficacy and safety of three antiseptics for neonatal skin disinfection: further evidence for chlorhexidine gluconate

Pediatric Research, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 7, 2025

Language: Английский

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Development and Validation of a Nosocomial Infection Nomogram Model in the NICU: A Novel and Nurse-Led Way to Prediction in Preterm Infants

Infection and Drug Resistance, Journal Year: 2025, Volume and Issue: Volume 18, P. 589 - 599

Published: Jan. 1, 2025

Nosocomial infections (NI) are a leading cause of mortality in preterm infants the Neonatal Intensive Care Unit (NICU). The key to reducing risk NI is early detection and treatment time. Nurses close observers primary caregivers for neonates at bedside NICU, who best positioned capture signals NI. This study aims develop nurse-led prediction model NICU. was designed as retrospective study, NICU Renmin Hospital Wuhan University from January 2020 December 2023 were selected divided into group non-NI group. Clinical data collected then analyzed by univariate analysis, least absolute shrinkage selection operator (LASSO) regression multivariate logistic analysis. outcome constructed nomogram its predictive efficacy evaluated area under receiver operating characteristic curve (AUC), calibration curve, decision analysis (DCA). Bootstrap method used repeat 1,000 times internal validation. A total 892 finally included established, which six variables: skin color changes, respiratory related feeding deterioration, birth weight, number arterial venous blood draws, days nasogastric tube placement. model's AUC 0.953, indicating good discriminatory power. plot demonstrated Hosmer-Lemeshow test showed high consistency. DCA indicated that had clinical utility. Internal validation 0.952. model, mainly based on nurses' observations, shows ability. It offered more convenient option neonatologists nurses

Language: Английский

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Hospital-onset bacteremia in the neonatal intensive care unit: strategies for risk adjustment

Infection Control and Hospital Epidemiology, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 7

Published: Feb. 17, 2025

Abstract Objective: To quantify the impact of patient- and unit-level risk adjustment on infant hospital-onset bacteremia (HOB) standardized infection ratio (SIR) ranking. Design: A retrospective, multicenter cohort study. Setting participants: Infants admitted to 284 neonatal intensive care units (NICUs) in United States between 2016 2021. Methods: Expected HOB rates SIRs were calculated using four strategies: birthweight (model 1), postnatal age 2), NICU complexity 3), birthweight, age, 4). Sites ranked according unadjusted rate, these rankings compared based adjusted SIR models. Results: Compared rate ranking (smallest largest), number proportion NICUs that left fourth quartile (worst-performing) following adjustments as follows: for (16, 22.5%), (19, 26.8%), (22, 31.0%), (23, 32.4%). Comparing moved into better-performing quartiles after those remained regardless adjustment, median percentage low infants was 17.1% (Interquartile Range (IQR): 15.8, 19.2) vs 8.7% (IQR: 4.8, 12.6); who died 2.2% 1.8, 3.1) 0.5% 0.01, 12.0), respectively. Conclusion: Adjusting patient one-third worst-performing a quartile. Risk may allow more accurate comparison across with varying levels acuity complexity.

Language: Английский

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Clinical characteristics, antimicrobial resistance, and mortality of neonatal bloodstream infections in Northern Tanzania, 2022–2023

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(3), P. e0319816 - e0319816

Published: March 25, 2025

Neonatal bloodstream infections (BSI) make a substantial contribution to morbidity and mortality in low- middle-income countries (LMICs), but data on the epidemiology antimicrobial resistance (AMR) Tanzania are limited. We describe prevalence, patterns, associated factors of neonatal BSI at Kilimanjaro Christian Medical Centre (KCMC), large referral hospital northern Tanzania. conducted prospective, observational study involving infants aged 0–60 days with perinatal risk or clinical signs sepsis. Aerobic blood cultures were obtained enrollment monitored using continuously culture instrument. Antimicrobial susceptibility testing was performed standard phenotypic methods. Vital status 2, 7, 28 post-enrollment. defined as isolation established pathogens, including yeast coagulase-negative Staphylococcus spp. (CoNS). Early-onset occurred day life (DOL) 0-2, while late-onset DOL 3 later. Among 236 enrolled infants, 233. 106 (45.5%) 233 50 (47.2%) early-onset, 56 (52.8%) BSI. The isolated pathogens included 58 (54.7%) Gram-positive bacteria, 40 (37.7%) Gram-negative 8 (7.5%) yeast. CoNS (n = 55, 51.9%) Klebsiella pneumoniae 35, 33.0%) most common pathogens. Notably, all K. isolates extended-spectrum beta-lactamase producers, resistant ampicillin ceftriaxone. who died, 29 (51.8%) had BSI; 11 (19.6%) EO-BSI, 18 (32.1%) LO-BSI. Infants requiring respiratory support admission 1.89-fold increased adjusted odds (95% CI, 1.05-3.44). found high prevalence due bacteria AMR, mortality. There is an urgent need for effective preventive, diagnostic, therapeutic interventions address among hospitalized

Language: Английский

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Epidemiology and Mortality of Invasive Staphylococcus aureus Infections in Hospitalized Infants

JAMA Pediatrics, Journal Year: 2025, Volume and Issue: unknown

Published: April 14, 2025

Importance Historically, Staphylococcus aureus has been a leading cause of morbidity and mortality in the neonatal intensive care unit (NICU). The current incidence attributable late-onset invasive S infection hospitalized infants is unknown. Objective To estimate among US. Design, Setting, Participants This retrospective cohort study included an emulated trial national convenience sample 315 NICUs within US between 2016 2021. were aged at least 4 postnatal days who participating NICU. Data analyzed from May to August 2024. Exposures primary exposures birth weight age. Main Outcomes Measures outcomes infection. Methicillin-resistant methicillin-sensitive classification was not universally available; thus, all infections pooled. Results From 468 201 (260 491 [55.6%] male; median [IQR] gestational age, 36 [33-38] weeks) eligible for analysis, 1724 experienced 1762 overall 37.6 (95% CI, 35.9-39.4) per 10 000 infants. Most with 32 weeks’ age or younger (1394 [80.9%]), very low (VLBW; ie, <1500 g) (1318 [76.5%]), and/or had central line during their hospital stay (1509 [87.5%]). Invasive mostly bloodstream (1505 [85.4%]), 1160 (65.8%) occurred 28 days. Birth inversely correlated incidence: VLBW more than 20-fold higher relative born weighing 1500 g (227.1 [95% 215.3-239.4] vs 10.1 9.1-11.1] infants). deaths following (189 209 [90.4%]). Compared matched without infection, infected absolute difference rate 5.3% 3.8%-6.8%). Conclusions Relevance found subsequent disproportionally affected VLBW. Targeted prevention control measures are necessary reduce this vulnerable population.

Language: Английский

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Hospital-Onset Bacteremia—Counting Them All

JAMA Pediatrics, Journal Year: 2024, Volume and Issue: unknown

Published: July 15, 2024

Language: Английский

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Outbreaks in the Neonatal Intensive Care Unit: Description and Management

Tropical Medicine and Infectious Disease, Journal Year: 2024, Volume and Issue: 9(9), P. 212 - 212

Published: Sept. 12, 2024

Healthcare settings, especially intensive care units, can provide an ideal environment for the transmission of pathogens and onset outbreaks. Many factors contribute to epidemic in a neonatal unit (NICU), including neonates' vulnerability healthcare-associated infections, those born preterm; facility design; frequent invasive procedures; contact with healthcare personnel. Outbreaks NICUs are one most relevant problems because they often caused by multidrug-resistant organisms associated increased mortality morbidity. The prompt identification outbreak, subsequent investigation identify source infection, risk factors, reinforcement routine infection control measures, implementation additional measures essential elements contain epidemic.

Language: Английский

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