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. 2015 Jan-Feb;19(1):52-7.
doi: 10.1016/j.bjid.2014.09.006. Epub 2014 Dec 15.

Late onset sepsis in newborn babies: epidemiology and effect of a bundle to prevent central line associated bloodstream infections in the neonatal intensive care unit

Daiane Silva Resende  1 , Anna Laura Gil Peppe  2 , Heloisio dos Reis  3 , Vânia Olivetti Steffen Abdallah  3 , Rosineide Marques Ribas  4 , Paulo Pinto Gontijo Filho  4
Affiliations

Late onset sepsis in newborn babies: epidemiology and effect of a bundle to prevent central line associated bloodstream infections in the neonatal intensive care unit

Daiane Silva Resende et al. Braz J Infect Dis. 2015 Jan-Feb.

Abstract

Aim: We assessed late onset sepsis (LOS) rates of neonates in a neonatal intensive care unit (NICU) before and after implementing an evidence-based bundle to prevent these infections in a country with poor resources.

Methods: We evaluate trends of LOS between October 2010 and August 2012 in a large tertiary hospital in Brazil. We designed a protocol based of CDC guidelines for insertion of maintenance of central venous catheter targeted to reduction of bloodstream infections. During this period two major events occurred: a great increase of LOS rates in January months and relocation of the unit to a provisory place. Additionally we evaluated the risk factors and etiology of these infections.

Results: A total of 112 (20.3%) cases defined as LOS were found. The overall incidence rate of LOS in the study was 16.1/1000 patient/days and 23.0/1000 CVC-days. Our monthly rates data of LOS/1000 patient-day reveal fluctuations over the studied period, with incidence rates of these infections in staff vacation period (January 2011 and 2012) significantly higher (59.6/1000 patients-days) than compared with the other months rates (16.6/1000 patients-days) (IRR=3.59; p<0.001). As opposite, the incidence rates of LOS during relocation period was lower (10.3/1000 patients-days) when compared with baseline period 26.7/1000 patients-days (IRR=2.59; p=0.007). After the intervention period, these rates decreased in the post intervention period, when compared with preintervention 14.7/1000 patients-days and 23.4/1000 patients-days, respectively (IRR=1.59; p=0.04).

Conclusion: Through simple infection control measures, LOS can be successfully controlled especially in NICUs of limited resources countries such as ours.

Keywords: Bundle; Late onset sepsis; Neonates.

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Figures

Fig. 1
Fig. 1
Monthly rates of late onset-sepsis per 1000 patient-days and per 1000 CVC-days from October 2010 to August 2012. LOS, late-onset sepsis; UAL, upper alert limit; UCL, upper control limit.
See this image and copyright information in PMC

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