Risk factors for nosocomial infections in critically ill newborns: A 5-year prospective cohort study

Background: Nosocomial infections (NIs) are one of the most important cause s of morbidity in neonatal intensive care units (NICUs). The aim of this st udy was to identify risk factors (RFs) for NIs among critically iii newborn patients in a Brazilian NICU. Methods: This 5-year prospective cohort study in an 8-bed NICU included all , infants born in the hospital and admitted to the NICU from 1993 to 1997. Exposure variables were maternal and newborn data prospectively collected f rom patient records. Univariate: and multivariate analyses were used to det ermine independent RFs associated with NIs. Results: Univariate analysis indicated gestational age, congenital abnormal ity, premature rupture of membranes, maternal illness, birth weight, mechan ical ventilation, central venous catheter, total parenteral nutrition, peri pheral venous catheter, and length of stay as possible RFs. Multivariate an alysis identified 5 independent RFs for NIs: premature rupture of membranes (hazard ratio [HR] = 1.51 [95% CI. 1.15-1.99]), maternal disease (HR = 1.5 7 [95% CI. 1.18-2.07]), mechanical ventilation (HR = 2.43 [95% CI, 1.67-3.5 3]), central venous catheter (HR = 1.70 [95% CI, 1.21-2.41]), and total par enteral nutrition (HR = 4.04[95% CI. 2.61-6.25]). Conclusions : The recognition of RFs for NIs is an important tool for the i dentification and development of interventions to minimize such risks in th e NICU.