Recent trends and prevention of infection in the neonatal intensive care unit

Survival of preterm and low birth weight neonates in increasingly advanced neonatal units has resulted in the rising incidence of healthcare-associated infections. This paper reviews recent trends in infection and its prevention in neonatal intensive care units.

Emerging pathogens in the developed world are predominantly Gram positive of which coagulase-negative staphylococci are the commonest organisms, accounting for 45-75% of all late-onset bloodstream infections. In the developing world, Gram-negative pathogens have persisted, but there is an increasing incidence of coagulase-negative staphylococci there too. Both settings have reported increases in multiresistant organisms including Candida spp. Interventions to combat these infections include renewed efforts to educate healthcare staff, national surveillance programmes and the use of prophylaxis against Candida spp. Despite many interventions, outbreaks continue to occur in both resource-rich and resource-poor settings and many lessons remain to be learnt by reviewing these reports.

Good infection control remains the mainstay of prevention of healthcare-associated infections in neonatal intensive care units. Whether in resource-rich or resource-poor settings, the key issues are emerging multiresistant pathogens and education of healthcare staff about prevention of infection particularly in preterm and low birth weight infants.