Reduction in late-onset sepsis on relocating a neonatal intensive care nursery

J Paediatr Child Health. 2012 Oct;48(10):891-5. doi: 10.1111/j.1440-1754.2012.02524.x. Epub 2012 Aug 16.

Abstract

Aims: The aims of this study were to compare rates of late-onset sepsis (LOS) in very preterm or very low birthweight infants before and after relocation to a new nursery and to determine risk factors for LOS.

Methods: The study was undertaken at The Royal Women's Hospital, Melbourne, which relocated to a new site in June 2008. Infants with birthweight <1500 g or <32 weeks' gestation, born between July and December 2007 (n= 149) and July and December 2008 (n= 152) were included. Each septic episode was identified from blood cultures taken from patients >48 h after birth and was categorised as definite, probable, uncertain or no sepsis.

Results: Overall, 117 infants had 218 septic episodes. The proportion of infants with clinical LOS decreased from 29.5% in 2007 to 22.4% in 2008 after the relocation, although this was not statistically significant. There was a significant (P < 0.05) reduction in the severity (definite LOS = most severe) of sepsis in 2008 compared with 2007, and in rates of coagulase-negative staphylococcal LOS. Significant risk factors for LOS were: lower birthweight (g; mean -351, 95% confidence interval (CI) -446, -256); lower gestational age (weeks; mean -2.3, 95% CI -2.8, -1.7) and presence of a percutaneous inserted central catheter (odds ratio (OR) 2.56, 95% CI 1.03, 6.67).

Conclusions: There was a significant reduction in the severity of LOS in very preterm and/or very low birthweight infants that correlated with the relocation from the old to new nursery. Smaller and more immature infants with percutaneous central catheters were more at risk.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross Infection / diagnosis
  • Cross Infection / epidemiology
  • Cross Infection / etiology
  • Cross Infection / prevention & control*
  • Health Facility Environment*
  • Health Facility Moving*
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / diagnosis
  • Infant, Premature, Diseases / epidemiology
  • Infant, Premature, Diseases / etiology
  • Infant, Premature, Diseases / prevention & control*
  • Infant, Very Low Birth Weight
  • Infection Control / methods*
  • Intensive Care Units, Neonatal*
  • Logistic Models
  • Retrospective Studies
  • Risk Factors
  • Sepsis / diagnosis
  • Sepsis / epidemiology
  • Sepsis / etiology
  • Sepsis / prevention & control*
  • Severity of Illness Index
  • Victoria