ArticleRevista de saude publica2022
Determinants of late neonatal nosocomial infection: a case-control study in Ceará.
Article in Revista de saude publica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 8 citations in OpenAlex.
- Case Report: Comprehensive management of bedside ligation of patent ductus arteriosus in an extremely low birth weight infant.Frontiers in cardiovascular medicine · 2026Article
- Development and Validation of a Nosocomial Infection Nomogram Model in the NICU: A Novel and Nurse-Led Way to Prediction in Preterm Infants.Infection and drug resistance · 2025Article
- The Extra Length of Stay, Costs, and Mortality Associated With Healthcare-Associated Infections: A Case-Control Study.Health science reports · 2024Article
- Risk factors of multidrug-resistant organisms neonatal sepsis in Surabaya tertiary referral hospital: a single-center study.BMC pediatrics · 2024Article
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Authors and funding
4 authors at 3 institutions in 3 countries.
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Abstract
objectivesTo assess the determining factors of late healthcare-associated infections (HAIs) and bacterial multiple drug resistance in neonatal intensive care.
methodsThis is a case-control study, conducted between January 2013 and December 2017, in a neonatal intensive care unit in the state of Ceará, Brazil. Newborns showing late HAIs were considered cases and those without infection, the control. Variables with p-values ≤ 0.05 in our initial bivariate regressive analysis were included in a non-conditional hierarchical logistic model for multivariate analysis. P-values below 0.01 were considered significant.
resultsOf the 1,132 participants, 427 (37.7%) showed late healthcare-associated infections. Of these, 54 (12.6%), positive blood cultures, of which 14.9% contained multidrug-resistant bacteria. Bivariate analysis showed the protective effect of the feminine phenotype (OR = 0.71; 95%CI: 0.56-0.90) and of gestational ages ≥ 34 weeks (OR = 0.48; 95%CI: 0.30-0.75). In earlier-born preterm infants, late infections were 18 times more likely in those with less than 30 week-gestations (OR = 18.61; 95%CI: 9.84-35.22) and four times higher in those weighing less than 1,500 g (OR = 4.18; 95%CI: 3.12-5.61). Mechanical ventilation increased infection odds by more than seven times (OR = 7.14; 95%CI: 5.26-9.09); as did parenteral nutrition (OR = 5.88; 95%CI: 4.54-7.69); central venous catheters (OR = 10.00; 95%CI: 6.66-16.66); the number of catheters used (OR = 3.93; 95%CI: 3.02-5.12); surgery (OR = 4.00; 95%CI: 2.27-7.14); and hospitalization time (OR = 1.06; 95%CI: 1.05-1.07). The association between preterm infants with less than 30 week-gestations (OR = 5.62; 95%CI: 1.83-17.28); mechanical ventilation (OR = 1.84; 95%CI: 1.26-2.68); central venous catheters (OR = 2.48; 95%CI: 1.40-4.37); and hospitalization time (OR = 1.06; 95%CI: 1.05-1.07) remained significant after adjustment. Among deaths, 41 (55.4%) were associated with late infections.
conclusionBetter practices should be adopted in caring for the premature, as well as in the rational use of procedures, to avoid late healthcare-associated infections, preventable deaths, and risks of bacterial multiple drug resistance and environmental contamination.
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