Preprint Article Version 2 This version is not peer-reviewed

Incidence and Determinants of Health Care Associated Blood Stream Infection at a Neonatal Intensive Care Unit in Ujjain, India: A Prospective Cohort Study

Version 1 : Received: 5 December 2017 / Approved: 5 December 2017 / Online: 5 December 2017 (08:19:17 CET)
Version 2 : Received: 27 January 2018 / Approved: 30 January 2018 / Online: 30 January 2018 (08:03:04 CET)

A peer-reviewed article of this Preprint also exists.

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. 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.

Journal reference: Diseases 2018, 6, 14
DOI: 10.3390/diseases6010014

Abstract

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 antibiotic interventions to reduce LCBIs in resource-limited settings.

Subject Areas

blood stream health care associated infections; neonates; risk factors, antibiotic use, antibiotic resistance; neonatal intensive care unit; India

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