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. 2023 Mar 30;12(7):2621.
doi: 10.3390/jcm12072621.

Incidence of Healthcare-Associated Infections in a Neonatal Intensive Care Unit before and during the COVID-19 Pandemic: A Four-Year Retrospective Cohort Study

Mariateresa Ceparano  1 , Antonio Sciurti  1 , Claudia Isonne  1 , Valentina Baccolini  1 , Giuseppe Migliara  1 , Carolina Marzuillo  1 , Fabio Natale  2 , Gianluca Terrin  2 , Paolo Villari  1 , The Collaborating Group
Affiliations

Incidence of Healthcare-Associated Infections in a Neonatal Intensive Care Unit before and during the COVID-19 Pandemic: A Four-Year Retrospective Cohort Study

Mariateresa Ceparano et al. J Clin Med. .

Abstract

The COVID-19 pandemic may have had an impact on healthcare-associated infection (HAI) rates. In this study, we analyzed the occurrence of HAIs in a neonatal intensive care unit (NICU) of the Umberto I teaching hospital in Rome before and during the pandemic. All infants admitted from 1 March 2018 to 28 February 2022 were included and were divided into four groups according to their admission date: two groups before the pandemic (periods I and II) and two during the pandemic (periods III and IV). The association between risk factors and time-to-first event was analyzed using a multivariable Cox regression model. Over the four-year period, a total of 503 infants were included, and 36 infections were recorded. After adjusting for mechanical ventilation, birth weight, sex, type of delivery, respiratory distress syndrome, and previous use of netilmicin and fluconazole, the multivariable analysis confirmed that being hospitalized during the pandemic periods (III and IV) was the main risk factor for HAI acquisition. Furthermore, a change in the etiology of these infections was observed across the study periods. Together, these findings suggest that patient management during the pandemic was suboptimal and that HAI surveillance protocols should be implemented in the NICU setting promptly.

Keywords: COVID-19; healthcare associated infection (HAI); neonatal intensive care unit (NICU).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Incidence rate of first healthcare-associated infection (HAI) occurring in patients admitted to the neonatal intensive care unit of Umberto I teaching hospital of Rome between March 2018 and February 2022 by study period.
Figure 2
Figure 2
(A–C) Incidence rate of first healthcare-associated infection (HAI) occurring in patients admitted to the neonatal intensive care unit of Umberto I teaching hospital of Rome between March 2018 and February 2022 by study period.
Figure 3
Figure 3
Frequency of isolation of microorganisms (N = 40) responsible for the healthcare-associated infections occurring in patients admitted to the neonatal intensive care unit of Umberto I teaching hospital of Rome between March 2018 and February 2022 by study period.
Figure 4
Figure 4
Kaplan–Meier survival estimates for time-to-first healthcare-associated infection (HAI) occurring in patients admitted to the neonatal intensive care unit of Umberto I teaching hospital of Rome between March 2018 and February 2022 by study period.
See this image and copyright information in PMC

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