Neonatal nosocomial infections

Nosocomial acquisition of infection is now the most common mode of transmission of infection in neonatal intensive care units (NICUs). Surveillance studies have shown rates of infection in the NICU of 15% to 20%, which are as high as those in adult medical or surgical ICUs and higher than those in most pediatric ICUs. Studies of NICU nosocomial infections have pinpointed the use of indwelling vascular catheters, high-calorie hyperalimentation infusions, assisted ventilation, and prior use of antibiotics as significant risk factors for infection. Strategies to reduce nosocomial infections with the use of prophylactic antibiotics, immunoglobulins, and physical barriers have been unsuccessful. New methods of reducing risk factors and enhancing the neonate's resistance to infection are badly needed.