Aim To document the changing pattern of nosocomial infection on a tertiary neonatal unit before and after the introduction of an infection control care bundle.
Nosocomial sepsis is a serious problem for neonates admitted for intensive care and may be related to suboptimal infection control measures.1
Methods Retrospective data on all positive blood cultures and infants admitted to the NICU were obtained for the periods 2002–2009 straddling the introduction of a range of measures in 2007 including improved skin antisepsis, hand washing training, audit and a standardised line handling e-learning module. Nosocomial sepsis was defined as a positive blood culture after 72 h of life.
Results Gestation, sex and birth weight were comparable in each period. The number of positive blood cultures (after 72 h) declined sequentially from 28.7 (2007) to 20.3 (2009) per 1000 ITU days, an overall 29.3% reduction. The number of infection episodes/1000 ITU days fell from 16.7 (2007) to 13.4 (2008) and 11.1 (2009). CONS were the predominant isolate (66.2% 2002–2007, 61.7% 2008–2009). CONS in addition to Staphylococcus aureus (20.2%) accounted for 82% of all nosocomial infections during 2008–2009. Gram negative organisms accounted for 8% in 2002–2007 as compared to 6.4% in 2008–2009.
Conclusion The introduction of a bundled infection control intervention on our unit is associated with a progressive decrease in the incidence of nosocomial infection.
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