Brief report
Neonatal rates and risk factors of device-associated bloodstream infection in a tertiary care center in Saudi Arabia

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In a prospective surveillance study, we examine the risk of device-associated bloodstream infection (BSI) in a neonatal intensive care unit at Riyadh, Saudi Arabia, during 2006 and 2007. The incidence per 1000 device-days was 8.2 for central line-associated BSI and 10.5 for umbilical catheter-associated BSI. Both rates were higher with more umbilical catheter and less central line utilization ratios compared with those reported by the American National Healthcare Safety Network hospitals. Concurrent with implementation of more strict infection control practices, BSI rates declined over the course of the study. Prolonged device duration was an independent risk factor for device-associated BSI.

Section snippets

Study population

The study was conducted at a 40-bed level II/III NICU that serves neonates born to families of the Saudi National Guard employees in the central region of Saudi Arabia. During the study period, the NICU received on average 10 neonates per week of different gestational ages (37% of neonates <33 weeks), weights (32% of neonates ≤1500 g), and levels of disease severity (75% on ventilator and 11% had surgery) out of approximately 160 live births at KAMC every week.

Data collection

Numerator data were collected from

Results

Out of 838 patients included in the current analysis, 102 patients developed BSI, and 40 fulfilled the criteria for device-associated BSI. The incidence per 1000 device-days was 8.2 for CLA-BSI and 10.5 for umbilical catheter-associated BSI (Table 1). For most of birth weight groups, the incidence rates of umbilical catheter-associated BSI and CLA-BSI were above the 75th or 90th percentile of NHSN hospitals. UC utilizations were generally higher, whereas CL utilizations were generally lower,

Discussion

We studied device-associated BSI rates and device utilization ratios at KAMC NICU over a 2-year period. Device-associated BSI in the current study was an important NICU problem associated with higher mortality. KAMC device-associated BSI rates were considerably above NHSN mean rates,4 especially at the start of the study. However, concurrent with the implementation of more strict infection control practices (starting March 2006), the rate of device-associated BSI, especially CLA-BSI, gradually

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Conflicts of interest: None to report.

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