Vigilância Epidemiológica "National Healthcare Safety Network" em Neonatos Críticos

Abstract

Introduction: The infection surveillance in the Neonatal Intensive Care Unit is of great importance since it is a well-established prevention measure to reduce the rates of infections related to long-term health care. Objectives: To realize an epidemiological surveillance in the Neonatal Intensive Care Unit of the University of Uberlândia Hospital, showing a rate of Infections related to Health Care, an occurrence of infections, main risk factors, etiological agents and the occurrence of outbreaks. Methodology: Cohort study, observational and prospective. Epidemiological surveillance was performed by the National Health Security Network system from January 2017 to June 2018. The neonates were monitored daily, with one form filled out for each inclusion. Results: There were 379 hospitalized neonates with an average length of stay of 22 days. Of these, 93 (24.5%) developed infection. The main risk factors were: use of central venous catheter, parenteral nutrition, drainage, mechanics, bladder catheter, antimicrobials and time of hospitalization. Of the 379 newborns, 56 died (14.7%), with the risk of death in the newborns they developed, twice as high as uninfected neonates. The most frequent infectious infection during the study was bloodstream infection (n = 62 / 52.5%) followed by conjunctivitis (n = 35 / 29.7%). Two hundred and six microorganisms were isolated: 107 were Gram-positive (52%), 86 Gram-negative (41.7%) and 13 fungi (6.3%). Staphylococcus epidermidis was the more predominant bacterium among Gram-positive (n = 58 / 54.2%), Klebsiella pneumoniae among Gram-negative (n = 23 / 26.7%) and Candida albicans among fungi (n = 9 / 69.2%). There were no outbreaks in the study period. Conclusion: Epidemiological surveillance of Neonatal Intensive Care Unit allows the recognition of the main risk factors, bacterial infections, etiological agents most prevalent and sites of infection. In this way it is possible to institute measures to prevent and control infections in this environment.