Risk factors for healthcare-associated infections in newborns after surgery in a neonatal intensive care unit

Health care-associated infections (HAIs) are a common cause of morbidity and mortality. There is little information on the risk factors associated with HAI in surgical newborns.

To identify the risk factors associated with healthcare-associated infections in surgical newborns.

Nested case-control study carried out during 2016-2017. Cases were newborns with healthcare-associated infections and controls were newborns without infection. Perinatal characteristics, use of antimicrobial prophylaxis, use of central venous catheter (CVC), mechanical ventilation, parenteral nutrition, age, and weight at the time of surgery, type of surgery, surgical wound classification, duration of surgery, number of surgical procedures, postsurgical HAIs and type of infection were registered. Univariate and multivariate analyses were performed.

Seventy-one cases and 142 controls were included. The most frequent HAI was bloodstream infection (36.6%); the main microorganisms isolated in blood cultures were gram-positive cocci. Independent risk factors associated with HAIs in the multivariate analysis were CVC duration > 8 days (aOR = 17.2, 95% CI = 3.8-49.1), ≥ 2 surgeries (aOR = 16.5, 95% CI 5.8 -42.1) and abdominal surgery (aOR = 2.6, 95% CI = 1.2-6.6).

Newborns undergoing surgery, mainly those with risk factors, require close monitoring during the postoperative period. CVC should be withdrawn as soon as possible.