Incidence and Determinants of Health Care-Associated Blood Stream Infection at a Neonatal Intensive Care Unit in Ujjain, India: A Prospective Cohort Study
by
Mamta Dhaneria 1, Sachin Jain 1, Poonam Singh 1, Aditya Mathur 1
, Cecilia Stålsby Lundborg 3 and Ashish Pathak 1,2,3,*
Mamta Dhaneria 1, Sachin Jain 1, Poonam Singh 1, Aditya Mathur 1, Cecilia Stålsby Lundborg 3 and Ashish Pathak 1,2,3,*
1
Department of Paediatrics, Ruxmaniben Deepchand Gardi Medical College, Ujjain 456006, Madhya Pradesh, India
2
Department of Women and Children’s Health, International Maternal and Child Health (IMCH) Unit, Uppsala University, SE-751 85 Uppsala, Sweden
3
Global Health—Health Systems and Policy: Medicines, Focusing Antibiotics, Department of Public Health Sciences, Karolinska Institutet, SE-171 77 Stockholm, Sweden
*
Author to whom correspondence should be addressed.
Diseases 2018, 6(1), 14; https://doi.org/10.3390/diseases6010014
Received: 4 December 2017 / Revised: 20 January 2018 / Accepted: 26 January 2018 / Published: 30 January 2018
(This article belongs to the Section Infectious Disease)
Very little is known about laboratory-confirmed blood stream infections (LCBIs) in neonatal intensive care units (NICUs) in resource-limited settings. The aim of this cohort study was to determine the incidence, risk factors, and causative agents of LCBIs in a level-2 NICU in India. The diagnosis of LCBIs was established using the Centre for Disease Control, USA criteria. A predesigned questionnaire containing risk factors associated with LCBIs was filled-in. A total of 150 neonates (43% preterm) were included in the study. The overall incidence of LCBIs was 31%. The independent risk factors for LCBIs were: preterm neonates (relative risk (RR) 2.23), duration of NICU stay more than 14 days (RR 1.75), chorioamnionitis in the mother (RR 3.18), premature rupture of membrane in mothers (RR 2.32), neonate born through meconium-stained amniotic fluid (RR 2.32), malpresentation (RR 3.05), endotracheal intubation (RR 3.41), umbilical catheterization (RR 4.18), and ventilator-associated pneumonia (RR 3.17). The initiation of minimal enteral nutrition was protective from LCBIs (RR 0.22). The predominant causative organisms were gram-negative pathogens (58%). The results of the present study can be used to design and implement antibiotic stewardship policy and introduce interventions to reduce LCBIs in resource-limited settings.
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Keywords:
blood stream health care associated infections; neonates; risk factors; antibiotic use; antibiotic resistance; neonatal intensive care unit; India
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
MDPI and ACS Style
Dhaneria, M.; Jain, S.; Singh, P.; Mathur, A.; Lundborg, C.S.; Pathak, A. Incidence and Determinants of Health Care-Associated Blood Stream Infection at a Neonatal Intensive Care Unit in Ujjain, India: A Prospective Cohort Study. Diseases 2018, 6, 14.
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