V. Khadilkar et al., A PROSPECTIVE-STUDY OF NOSOCOMIAL INFECTION IN A NEONATAL INTENSIVE-CARE UNIT, Journal of paediatrics and child health, 31(5), 1995, pp. 387-391
Objective: To determine the incidence of and organisms responsible for
neonatal nosocomial infection (after 72 h of age). Methodology: A 1-y
ear evaluation of 321 consecutive septic work-ups performed on 130 of
1008 babies admitted to a neonatal intensive care unit (NICU) for more
than 72 h. Fifty-seven (89%) of 64 infants of birthweight 500-999 g,
36 (34%) of 105 infants 100-1499 g, 27 (6%) of 422 infants 1500-2499 g
and 10 (28%) of 477 infants of birthweight >2500 g had at least one s
eptic work-up. Results: In addition to blood culture, the evaluations
included haematological score on full blood count in 94.7%, abdominal
X-ray in 48%, endotracheal tube tip culture in 32.7% and lumbar punctu
re in only 13.1%. Blood culture was positive on 92 occasions in 75 inf
ants (28.7% of work-ups and 7.4% of all babies admitted). Infection st
atus was classified as definite on 40 occasions in 30 babies, and due
to contamination 52 in 45 babies. Twenty of the 30 babies with definit
e infection were of birthweight 500-999 g. Of the 40 definite infectio
ns coagulase-negative staphylococci(CONS) were cultured from 23 babies
, Gram negative bacilli in 14 and Candida spp. in three babies. Sepsis
caused or contributed to the deaths of six babies. Conclusion: This s
tudy identifies infants of birthweight <1000 g as the highest risk gro
up for nosocomial infection especially CONS. New strategies in prevent
ion, surveillance and treatment are required for extremely low birthwe
ight infants.