Amy R Zipursky1, Eugene W Yoon2, Julie Emberley3, Valerie Bertelle4, Jaideep Kanungo5, Shoo K Lee6, Prakesh S Shah7. 1. Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. 2. Maternal-Infant Care Research Center, Mount Sinai Hospital, Toronto, Ontario, Canada. 3. Department of Pediatrics, Janeway Children's Health & Rehabilitation Center and Memorial University of Newfoundland, St. John's, Newfoundland, Canada. 4. Department of Pediatrics, University of Sherbrooke, Sherbrooke, Quebec, Canada. 5. Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; Island Medical Program, University of Victoria, Victoria, British Columbia, Canada. 6. Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Maternal-Infant Care Research Center, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Obstetrics and Gynecology and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. 7. Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Maternal-Infant Care Research Center, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.
Abstract
OBJECTIVE: To determine if the reported reduction in hospital-acquired infections is due to reduced central line-associated blood stream infections (CLABSI) or non-CLABSIs. STUDY DESIGN: A retrospective cohort study design was used to describe the change in organism pattern and incidence of hospital-acquired infections (CLABSIs and non-CLABSIs) in neonates <33 weeks of gestation admitted to tertiary neonatal intensive care units in the Canadian Neonatal Network between January 1, 2010, and December 31, 2016. Hospital-acquired infection was diagnosed when a pathogenic organism was isolated from blood or cerebrospinal fluid in a neonate with suspected sepsis. CLABSI was diagnosed when a central venous catheter was present at the time or removed in the 2 days before a hospital-acquired infection diagnosis. Cochran-Armitage and Mann-Kendall trend tests and linear regression models were used for statistical analyses. RESULTS: Of 28 144 eligible neonates from 30 Canadian Neonatal Network neonatal intensive care units, 3306 (11.7%) developed hospital-acquired infections. There was a significant decrease in the rate of hospital-acquired infections (14.2% in 2010 and 9.2% in 2016; P < .01), and the rate of both CLABSIs and non-CLABSIs (P < .01) over the study period concomitant with a significant decrease in the duration of central line use (P = .01). The rates of meningitis also decreased during the study period (1.2% in 2010 and 0.9% in 2016; P < .01). Infections owing to gram-positive cocci significantly decreased, but infections owing to gram-negative organisms remained unchanged. CONCLUSION: Although there was a significant decrease in CLABSIs and non-CLABSIs, hospital-acquired infections in preterm neonates remained high. Infections owing to gram-negative organisms remained unchanged and are a target for future preventative efforts. Crown
OBJECTIVE: To determine if the reported reduction in hospital-acquired infections is due to reduced central line-associated blood stream infections (CLABSI) or non-CLABSIs. STUDY DESIGN: A retrospective cohort study design was used to describe the change in organism pattern and incidence of hospital-acquired infections (CLABSIs and non-CLABSIs) in neonates <33 weeks of gestation admitted to tertiary neonatal intensive care units in the Canadian Neonatal Network between January 1, 2010, and December 31, 2016. Hospital-acquired infection was diagnosed when a pathogenic organism was isolated from blood or cerebrospinal fluid in a neonate with suspected sepsis. CLABSI was diagnosed when a central venous catheter was present at the time or removed in the 2 days before a hospital-acquired infection diagnosis. Cochran-Armitage and Mann-Kendall trend tests and linear regression models were used for statistical analyses. RESULTS: Of 28 144 eligible neonates from 30 Canadian Neonatal Network neonatal intensive care units, 3306 (11.7%) developed hospital-acquired infections. There was a significant decrease in the rate of hospital-acquired infections (14.2% in 2010 and 9.2% in 2016; P < .01), and the rate of both CLABSIs and non-CLABSIs (P < .01) over the study period concomitant with a significant decrease in the duration of central line use (P = .01). The rates of meningitis also decreased during the study period (1.2% in 2010 and 0.9% in 2016; P < .01). Infections owing to gram-positive cocci significantly decreased, but infections owing to gram-negative organisms remained unchanged. CONCLUSION: Although there was a significant decrease in CLABSIs and non-CLABSIs, hospital-acquired infections in preterm neonates remained high. Infections owing to gram-negative organisms remained unchanged and are a target for future preventative efforts. Crown
Authors: Gaelle Bury; Stéphanie Leroux; Cristhyne Leon Borrego; Christèle Gras Leguen; Delphine Mitanchez; Geraldine Gascoin; Aurore Thollot; Jean Michel Roué; Guy Carrault; Patrick Pladys; Alain Beuchée Journal: Int J Environ Res Public Health Date: 2021-01-20 Impact factor: 3.390
Authors: Noa Fleiss; Sarah A Coggins; Angela N Lewis; Angela Zeigler; Krista E Cooksey; L Anne Walker; Ameena N Husain; Brenda S de Jong; Aaron Wallman-Stokes; Mhd Wael Alrifai; Douwe H Visser; Misty Good; Brynne Sullivan; Richard A Polin; Camilia R Martin; James L Wynn Journal: JAMA Netw Open Date: 2021-02-01
Authors: Sophie J Jansen; Alieke van der Hoeven; Thomas van den Akker; Marieke Veenhof; Erik G J von Asmuth; Karin Ellen Veldkamp; Monique Rijken; Martha van der Beek; Vincent Bekker; Enrico Lopriore Journal: Eur J Clin Microbiol Infect Dis Date: 2022-09-30 Impact factor: 5.103