Multicenter study on epidemiology of deviceassociated infection in neonatal intensive care units

Abstract:

ObjectiveTo investigate the epidemiological characteristics of deviceassociated infection (DAI) in neonatal intensive care units（NICUs）of tertiary firstclass hospitals in China,  and provide scientific evidence for the prevention and control of neonatal DAI.MethodsNeonates in NICUs at 17 hospitals of 9 provinces from October 2013 to September 2014 were selected for multicenter study, DAI was surveyed prospectively according to the uniform diagnostic criteria and methods.ResultsA total of 12 998 neonates were monitored, the total patientdays were 126 125 d, 13 cases of central lineassociated bloodstream infection (CLABSI) and 70 cases of ventilatorassociated pneumonia (VAP) occurred, central line utilization rate was 15.56%, incidence of  CLABSI was 0.66/1 000 devicedays; ventilator utilization rate was 7.67%, incidence of VAP was 7.23/1 000 devicedays. Utilization rates of central line and respirator in neonates with body weight ≤1 000 g was the highest, which were 61.06% and 29.91% respectively; In NICUs with 2030 beds, utilization rate of central line was the highest(16.67%),and respirator was the lowest(4.11%);of  hospitals in different regions, central line and respirator utilization rate in southwest China was the highest. Of different sizes  of ICUs, VAP per 1 000 devicedays was the lowest in NICUs with 2030 beds(2.36 ‰) . Difference in incidence of CLABSI and VAP per 1 000 devicedays in neonates at NICUs of different regions were  significantly different; incidence of CLABSI and VAP per 1 000 devicedays was highest in southern China(2.68 ‰ and 31.06‰ respectively),followed by southwest region. Of different quarters, incidence of CLABSI, and VAP per 1 000 devicedays were not significantly different(all P>0.05).ConclusionDevice utilization rate and incidence of DAI in China are both high, and are different in neonates of  different birth weight, at different sizes of NICUs, as well as different regions, monitoring should be intensified, prevention and control measures should be implemented according to infection characteristics.
［Key words］neonatal intensive care unit; central lineassociated bloodstream infection; ventilatorassociated pneumonia; epidemiology; multicenter study