Risk factors for intrahospital infection in newborns

Background. Intrahospital infection (IHI) in the newborn (NB) is a morbidit y problem that increases mortality rates in this age group because the infe cting microorganism is more aggressive. The objective of this study was to compare risk factors for localized or systemic IHIs between groups of NBs w ith and without IHIs. Methods. This was a retrospective study of two groups of patient records fr om January 1995 to December 1998. Group A (cases) was made up of 73 patient s with documented IHIs and Group B (controls), 105 patients without IHIs. D escriptive and inferential statistics (Student t, Mann-Whitney U, Wilcoxon rank sum, Chi square, and Fisher exact tests) were used. Odds ratio (OR) an d multiple logistic regression were used to study risk factors. Statistical significance was considered at p <0.05. Results. Average gestational age was 35.4 +/- 4.3 weeks in Group A patients and 37.4 +/- 3.2 weeks for Group B patients with p = 0.001. Risk factors s tudied by means of OR (low birth weight, prematurity of 30 weeks of gestati onal age or less, prolonged intrahospital stay, etc.) showed statistical si gnificance. Also showing significance were other not-well-studied factors s uch as higher numbers of diagnoses and blood transfusions. After multivaria te analysis, the group of risk factors more associated with IHIs included v ein dissection for insertion of central venous catheter, orotracheal intuba tion, and prolonged intrahospital stay (12 days or more) with an accumulati ve r of 0.6112. Conclusions. We conclude that there are several known risk factors for IHIs and others not well described to date that must be avoided to the extent p ossible in the NB, particularly in the premature newborn population. (C) 20 01 IMSS. Published by Elsevier Science Inc.