Artikel
Risk factors for nosocomial infections for newborn children with very low birth weight: Data from the German Nosocomial Infection Surveillance System for Neonatal Intensive Care Units (NEO-KISS)
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Autoren
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Frank Schwab
- Institit für Hygiene und Umweltmedizin, Charité – Universitätsmedizin Berlin, Berlin
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Christine Geffers
- Institit für Hygiene und Umweltmedizin, Charité – Universitätsmedizin Berlin, Berlin
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Sina Bärwolff
- Institit für Hygiene und Umweltmedizin, Charité – Universitätsmedizin Berlin, Berlin
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Henning Rüden
- Institit für Hygiene und Umweltmedizin, Charité – Universitätsmedizin Berlin, Berlin
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Petra Gastmeier
- Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Medizinische Hochschule Hannover, Hannover
| Veröffentlicht: | 8. September 2005 |
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Gliederung
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Background
The risk to received a Nosocomial Infection (NI) is highest for neonates with very low birth weight on Neonatal Intensive Care Units (NICUs).
Objective
To investigate risk factors for the two kinds of NIs primary Bloodstream Infection (BSI) or Pneumonia for newborn children with birth weight < 1500g on NICUs.
Methods
NI surveillance data comes from neonatal departments participating voluntarily in NEO-KISS during the period from January 2000 to June 2003. Data was collected patient-based (patients on NICUs with birth weight <1500g until discharge, dead or weight>1,800g). For the definition of BSI and pneumonia modified CDC-definitions were used. For all patients patient-based variables were collected: birth weight, sex, multiple labor, gestational age and type of delivery (vaginal delivery/ cesarean section(CS)).
In an univariate analysis factor levels were compared using the fishers exact test and odds ratios (OR) were calculated. Using the Kaplan Meier method the survival functions for the factor levels were compared. A Cox proportional hazards regression was carried out to identify independent risk factors. Significance level was p<0.05.
Results
35 neonatal departments with a total of 4,071 patients (164,657 patient days) experienced 1,404 NI (1,240 BSIs and 164 pneumonias). Incidence-density was 8.5 NI per 1,000 patient days and incidence 34.5 NI per 100 patients. 1,092 patients (26.8%) acquired at least on NI.
2,395 neonates with birth weight < 1,000g, 1,374 neonates with gestational age < 30 week, 3,468 neonates with vaginal delivery and 1,121 neonates from simple labor acquired significantly more frequently a first NI than neonates without presence of the appropriate characteristic. Cox-regression model identify birth weight, gestational age and vaginal delivery as independent risk factors.
Conclusions
Birth weight and gestational age are well-known risk factors for NI. An interesting result is that CS is a protective factor.
