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Related Concept Videos

Healthcare Associated Infections II: Preventive Measures01:22

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Pneumonia I: Introduction01:30

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Standard Precaution01:26

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Transmission-based precautions are for patients infected or suspected to be infected (or colonized) with organisms posing a significant risk to others. The transmission precautions include airborne and protective environment precautions.
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A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
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Risk Factors for Health Care-Associated Bloodstream Infections in NICUs.

Julia Johnson1,2, Sudhir Malwade3, Sharad Agarkhedkar3

  • 1Division of Neonatology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.

JAMA Network Open
|March 25, 2025
PubMed
Summary
This summary is machine-generated.

Health care-associated bloodstream infections (BSIs) are a significant risk for neonates in intensive care. Indwelling devices and prior antibiotic exposure increase BSI risk in newborns, necessitating targeted prevention strategies.

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Area of Science:

  • Neonatal Intensive Care Unit (NICU) care
  • Infectious Diseases
  • Public Health

Background:

  • Neonates in intensive care units (NICUs) face a high risk of health care-associated infections (HAIs).
  • Identifying modifiable risk factors in low-resource settings is crucial for reducing neonatal morbidity and mortality.
  • Health care-associated bloodstream infections (BSIs) are a major concern in neonatal intensive care.

Purpose of the Study:

  • To determine the incidence of health care-associated BSIs in NICUs in Pune, India.
  • To identify risk factors associated with health care-associated BSIs in this population.
  • To inform targeted prevention strategies for neonatal infections.

Main Methods:

  • A multicenter prospective cohort study involving neonates admitted to 3 NICUs in Pune, India.
  • Follow-up from admission until discharge, transfer, or death.
  • Secondary data analysis of neonates admitted for at least 3 days, with specific assessment of antibiotic exposure for those admitted for 7 days or longer.

Main Results:

  • The incidence of health care-associated BSIs was 6.09 per 1000 patient-days among 6410 neonates.
  • Gram-negative organisms were the most common isolates, with high rates of antibiotic resistance.
  • Risk factors included central venous catheters, respiratory support, and urinary catheters; prior antibiotic exposure increased BSI risk by nearly 3-fold (aHR, 2.82).

Conclusions:

  • Health care-associated BSIs in neonates are linked to indwelling devices and previous antibiotic use.
  • Interventions should focus on minimizing risks from indwelling devices.
  • Strengthening infection prevention and control, alongside antimicrobial stewardship, is vital for preventing HAIs in NICUs.