Infection Surveillance in Polish Neonatology Intensive Care Units. Pilot study

Background: Newborns in neonatal intensive care units (NICU) are at high risk for nosocomial infections. The most important risk factors are invasive devices and frequent use of antimicrobials.

Objective: In 2009, the newly established the Polish Neonatology Surveillance Network (Polska Siec Neonatologiczna) started to implement its surveillance system in 6 Neonatology Intensive Care Units (NICUs).

Methods: Data collection on infections in newborns with a very low birth weight (VLBW) was made prospectively according to the NeoKISS (the German surveillance system for very-low-birth weight infants). The newborns were monitored from < 1 500 g until discharge > 1 800 g or death. Surveillance included main types of infections: BSI, VAP, NEC and SSI. Incidence density and device-associated infection rates are calculated and stratified according to different birth weight categories: <750 g; 751-1000 g; <1001-1500 gram. Results: This pilot study covered 76 infections (CVC-BSI, VAP and NEC) detected among 201 VLBW neonates in 2 NICUs.

Birth weight [g] / Infections type	NICU A	NICU B
CVC-BSI	No of infections/ 1000 CVC-pds
<750	18,18	11,40
751-1000	33,11	7,61
1001-1500	4,58	8,40
VAP	No of infections/ 1000 ventilator-pds
<750	4,67	25,40
751-1000	5,19	22,64
1001-1500	0,00	21,39
NEC	No of infections/1000 pds
<750	2,99	4,59
751-1000	1,34	3,53
1001-1500	3,83	0,55

Conclusions: Our pilot study brought data showing a wide variation in infection indicators between two compared NICUs (A and B). Such situation indicates necessity of making at first careful analysis of epidemiological situations and then introducing effective activities in the field of prevention of hospital acquired infections among patients of NICUs and implementation of preventive strategies to reduce infection rates in these infants should be our priority.