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Decrease in healthcare-associated infection rates in preterm infants-longitudinal data from 15 years of nationwide
Ferenc Darius Ruether1,2, Frank Schwab1,2, Gizem Karadağ1,2
1Institute of Hygiene and Environmental Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlinhttps://ror.org/001w7jn25, Berlin, Germany.
Objective:
Although preterm infants are prone to healthcare-associated infections (HAI), HAI surveillance in neonates is still not widely practiced. In this paper, we present the HAI rates subsequent to nationwide implementation of NEO-KISS, the German national surveillance system for HAI in high-risk neonates. We also report on risk factors for the development of HAI in this population.
Design:
Observational study.
Setting:
German National Reference Centre for Surveillance of Nosocomial Infections, responsible for the maintenance of NEO-KISS.
Patients:
Infants with a birth weight of less than 1500 g.
Methods:
NEO-KISS data from the years 2008-2022 was analyzed retrospectively and incidence densities were calculated (in five-year reference periods) for different types of healthcare-associated sepsis (HAS), healthcare-associated pneumonia (HAP), and necrotizing enterocolitis (NEC). Rates were analyzed with Cox-proportional hazard regression models.
Results:
A total of 118,214 infants with a birth weight of less than 1500 g from 251 neonatology departments were included. They comprised 15,254 HAS, 1,657 HAP, and 2,786 NEC. The incidence densities of HAS and HAP were 33.3% and 46.7% lower in the admission period 2018-2022 compared to 2008-2012 (2.98 vs. 4.47 HAS, 0.3 vs. 0.56 HAP, per 1,000 patient days). In the multivariable regression analysis, the period of admission remained significant after adjustment for independent risk factors for HAS, HAP, and NEC.
Conclusions:
In Germany, the surveillance data for neonates in NEO-KISS between 2008 and 2022 showed a nationwide decrease in incidence densities of HAS, HAP, and NEC. The continuous engagement with NEO-KISS surveillance data may have contributed to this reduction.
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