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Updated: Jul 8, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
A systematic review and meta-analysis of outbreaks in neonatal intensive care units
Eric S Donkor1, Anastasia A Asantewaa1, Alex Odoom1
1Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra, Ghana.
Background:
Neonatal intensive care units (NICUs) are designed to provide specialized care for newborns in urgent need of medical interventions. However, these environments can also facilitate the spread of infections, leading to outbreaks. In this review, we analyse reported outbreaks associated with NICUs over two decades.
Methods:
Electronic databases including PubMed, Scopus, Web of Science, Google Scholar, and Outbreak Database were searched to identify studies reporting outbreaks that occurred in NICUs between January 2004 and October 2024. Data were synthesized thematically and presented through narrative summaries, tables, and figures. A random-effect meta-analysis was conducted to pool incidence and mortality rates.
Results:
Out of 4853 identified records, 119 studies met the inclusion criteria, documenting 122 outbreaks across 42 countries. Bacteria caused 80.3% of outbreaks, with the main pathogens being Klebsiella pneumoniae and Serratia marcescens. The main risk factors were prematurity and low birth weight, with healthcare workers' (HCWs') hands identified as the main transmission route.
Conclusions:
Infections in NICUs leading to outbreaks have been strongly associated with HCWs. Educating staff on effective infection prevention strategies as well as implementing stringent infection prevention and control strategies is crucial in preventing future outbreaks and improving patient safety.
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