Major ArticleRisk factors for late-onset health care–associated bloodstream infections in patients in neonatal intensive care units
Section snippets
Sample and setting
This study was 1 component of a larger prospective trial to assess the effect of staff hand hygiene on HAI in neonates performed in 2 NICUs from March 2001 through January 2003.10 During the study, either a traditional antiseptic soap containing 2% chlorhexidine gluconate or a waterless hand rinse containing 60% ethyl alcohol was used by all staff and visitors sequentially for half of the study period (11 months for each product) in a randomly assigned crossover design; no significant
Results
The characteristics of neonates with and without a health care-associated BSI are summarized in Table 1. In all, 2935 neonates were included in this study. Of these, 205 (7.0%) developed a bacterial BSI. The mean age of neonates at the time of the first health care-associated BSI was 21.4 days in NICU 1 and 35.7 days in NICU 2. Eighteen percent of neonates developed their first bacterial BSI after 30 days of life. Rates of BSI by unit were 18.5/1000 catheter days in NICU 1 and 13.0/1000
Discussion
This is one of the largest studies to assess prospectively the risk factors for late-onset health care-associated BSI in the NICU population. Not surprisingly, we found that central venous catheters and lower birth weight placed infants at a higher risk of developing bacterial BSI, as has been shown in other studies.6, 7, 8, 13, 14 We also noted that study site was a significant predictor of BSI, even after controlling for differences in birth weight. Although neonates in NICU 2 had a longer
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Supported by grant 5 RO1 NR05197 from the National Institutes of Health National Institute for Nursing Research, Bethesda, MD.