Department of Environmental Health Science and Technology, Jimma University, Jimma, Ethiopia.
Department of Statistics, College of Natural, Jimma University, Jimma, Ethiopia.
BMC Infect Dis. 2024 Oct 21;24(1):1185. doi: 10.1186/s12879-024-10069-w.
Neonatal Nosocomial infections (NNIs) are a significant cause of morbidity and mortality for neonates in an intensive care unit. Neonatal causes of death in healthcare facilities are attributed to different factors. We aimed to investigate factors associated with NNIs, estimate the burden of NNIs, and assess how the prediction effects help to save medical mortality and length of hospital stay.
A prospective longitudinal study was conducted and data were collected from January 2022 to June 2022 from Jimma University Medical Center (JUMC). The data were gathered in a variety of ways, including an in-person interview with the patient's caregiver, direct observations of neonatal patients, and a review of the study participants' charts. This study includes patients aged 3 to 28 days who were admitted to the JUMC neonatal ward and stayed for at least 48 h. Multi-state model formulation and multivariate logistic regression were used for data analysis.
A total of 545 neonates were included out of 688, and 30% (n = 164) of them acquired nosocomial infections (NIs); 98 (33%) of infected patients were born prematurely; and 71 (31.4%) were underweight at birth. NIs were higher in neonates with long hospital stay (AOR: 1.16, 95%CI: 1.13-1.20), use of urinary catheters (AOR: 3.09, 95%CI: 1.55-6.15), and undergoing surgical procedures (AOR: 2.42, 95%CI: 1.13-5.17). Patients who developed NIs had a higher risk of death (HR: 2, 95% CI: 1.31, 3.04). The burden of neonatal NIs was determined to have a risk of 0.3, a mortality rate of 9.6%, and an average duration of hospital stay of 14.6 days. Competing risk regression suggests that neonates with NIs have a significantly higher risk of death than those who are not infected (HR: 16.42, 95% CI: 8.70-30.98, p < 0.001). Assumed prevention that decreases the NIs rate in half would result in 101 lives and 1357 patient days saved from 10,000 neonatal inpatients.
Urinary catheterization and surgical procedure increased neonatal NIs. Longer hospital stay can increase the risk of NIs and can also result from the NIs. Our finding indicated that effective prevention of NIs could help reduce neonatal deaths and their hospital stays.
新生儿医院感染（NNI）是重症监护病房新生儿发病率和死亡率的重要原因。医疗机构中新生儿死亡的原因归因于不同的因素。我们旨在调查与 NNI 相关的因素，估计 NNI 的负担，并评估预测效果如何有助于降低医疗死亡率和住院时间。
本研究采用前瞻性纵向研究，于 2022 年 1 月至 2022 年 6 月期间从 Jimma 大学医学中心（JUMC）收集数据。数据收集的方式包括与患者照顾者进行面对面访谈、直接观察新生儿患者以及查阅研究参与者的病历。本研究包括年龄在 3 至 28 天之间、入住 JUMC 新生儿病房且至少住院 48 小时的患者。多状态模型制定和多变量逻辑回归用于数据分析。
在 688 名患者中，共有 545 名患者被纳入研究，其中 30%（n=164）发生了医院感染（NI）；98 名（33%）感染患者为早产儿；71 名（31.4%）出生时体重不足。住院时间较长的新生儿（AOR：1.16，95%CI：1.13-1.20）、使用导尿管（AOR：3.09，95%CI：1.55-6.15）和接受手术的新生儿（AOR：2.42，95%CI：1.13-5.17）发生 NI 的风险更高。发生 NI 的患者死亡风险更高（HR：2，95%CI：1.31-3.04）。新生儿 NIs 的负担被确定为风险为 0.3，死亡率为 9.6%，平均住院时间为 14.6 天。竞争风险回归表明，感染 NIs 的新生儿死亡风险明显高于未感染的新生儿（HR：16.42，95%CI：8.70-30.98，p<0.001）。假设将 NIs 发生率降低一半，可以从 10000 名新生儿住院患者中挽救 101 条生命和 1357 个患者日。
导尿管和手术增加了新生儿 NIs。较长的住院时间会增加 NIs 的风险，并且也可能是由 NIs 引起的。我们的研究结果表明，有效预防 NIs 可以帮助降低新生儿的死亡率和住院时间。
