Vigilância national healthcare safety network (nhsn) em um unidade de terapia intensiva neonatal (utin): fatores de risco para infecção e perfil de resistência a antimicrobianos.

Abstract

Introduction: Neonatal infection is the major cause of morbidity and mortality in newborns, with sepsis being the main infectious syndrome followed by conjunctivitis and urinary tract infections. Objectives: To perform data analysis of neonates hospitalized in the Neonatal Intensive Care Unit (NICU) emphasizing the etiological characteristics, resistance profile and infectious syndromes, as well as risk factors for infection and outbreak analysis. Materials and methods: following the NHSN surveillance system of neonates hospitalized at the unit during the from January 2013 to December 2016, following the criteria of inclusion and exclusion for data collection. Results: A total of 958 newborns hospitalized in the NICU of the Clinical Hospital of the Federal University of Uberlândia (HC-UFU). Two 958 neonates were analyzed, 27.5% developed infection and 72.4% did not develop. The Statistically significant risk factors for infection were venous catheter use (CVC), CVC use for more than 7 days, use of mechanical ventilation, use of parenteral nutrition, Intracath (central venous access) and drain. Diseases related to digestive and nervous systems were also statistically significant, as well as the antimicrobial use, the use of more than 3 antimicrobials, longer hospitalization time to 7 days and SNAP of 22-60 and greater than 61. It was found predominance of bacteria gram-positive bacteria and an increase of the isolates of gram-negative bacteria and fungi. There was an outbreak of the bacterium Pantoea agglomerans, detected in the months of September to November in the year 2013. Conclusions: The main risk factors for infection found in the study were SNAP range of 22-60 and> 61, use of antimicrobial, as well as use of more than 3 antimicrobials, use of PICC for more than 15 days and hospitalization for more than 7 days. The gram-negative bacteria presented a increase in resistance during the study period. In 2013 an outbreak was detected of Pantoea agglomerans started in the month of September 2013 to November of the same year, due to a contamination in the parenteral nutrition of these neonates. With this, the epidemiological surveillance becomes of paramount importance to assist in the prevention of particularly in the prevention of outbreaks.