5 research outputs found
Evaluation of national health-care related infection criteria for epidemiological surveillance in neonatology
OBJECTIVE: to assess the use of the Brazilian criteria for reporting of hospital-acquired infections (HAIs) in the neonatal unit and compare them with the criteria proposed by the National Healthcare Safety Network (NHSN). METHODS: this was a cross-sectional study conducted from 2009 to 2011. It included neonates with HAI reporting by at least one of the criteria. Statistical analysis included calculation of incidence density of HAIs, distribution by weight, and by reporting criterion. Analysis of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the national criteria was performed considering the NHSN as the gold standard, with agreement assessed by kappa. RESULTS: a total of 882 newborns were followed, and 330 had at least one infection notified by at least one of the criteria. A total of 522 HAIs were reported, regardless of the criteria. An incidence density of 27.28 infections per 1,000 patient-days was observed, and the main topographies were sepsis (58.3%), candidiasis (15.1%), and conjunctivitis (6.5%). A total of 489 (93.7%) were notified by both criteria, eight infections were notified only by the national criteria (six cases of necrotizing enterocolitis and two cases of conjunctivitis), and 25 cases of clinical sepsis were reported by NHSN criteria only. The sensitivity, specificity, PPV, and NPV were 95.1%, 98.6%, 98.4%, and 95.7%, respectively, for all topographies, and were 91.8%, 100%, 100%, and 96.3% for the analysis of sepsis. Kappa analysis showed an agreement of 96.9%. CONCLUSION: there was a high rate of agreement between the criteria. The use of the national criteria facilitates the reporting of sepsis in newborns, and can help to improve the specificity and PPV
Risk factors for central venous catheter-related infections in a neonatal population â systematic review
Objective: This was a systematic review of the incidence density and risk factors for central venous catheter-related infections in a neonatal population. Data source: The MEDLINE, Embase, Cochrane, BDENF, SciELO, and LILACS databases were used without date or language restriction. Studies that analyzed risk factors for bloodstream infections in newborns were identified. Data synthesis: A total of 134 articles were found that met the eligibility criteria. Of these articles, 14 were selected that addressed risk factors for central venous catheter-related infection in neonates. Catheter-related bloodstream infections remain an important complication, as shown by the incidence rates reported in the studies included in this review. The observed risk factors indicate that low birth weight, prematurity, and longer catheter permanence are related to a higher incidence of bloodstream infections. It has been observed that low rates of catheter-related infections, i.e., close to zero, are already a reality in health institutions in developed countries, since they use infection surveillance and control programs. Conclusion: Catheter-related bloodstream infections still show high incidence density rates in developing countries. The authors emphasize the need for further longitudinal studies and the need for better strategies to prevent risk factors, aiming at the reduction of catheter-related infections. Resumo: Objetivo: Trata-se de uma revisĂŁo sistemĂĄtica sobre a densidade de incidĂȘncia e de fatores de risco para infecção associada a cateter venoso central em população neonatal. Fontes dos dados: Utilizou-se os bancos de dados Medline, Embase, Cochrane, Bdenf, Scielo, Lilacs, sem restrição de data ou de idioma. Identificaram-se os estudos que analisaram fatores de risco para infecção da corrente sanguĂnea em recĂ©m-nascidos. SĂntese dos dados: Foram encontrados 134 artigos conforme os critĂ©rios de elegibilidade. Destes artigos, foram selecionados 14 que abordaram fatores de risco para infecção associada a cateter venoso central em neonatos. A infecção da corrente sanguĂnea associada a cateter continua a mostrar-se como uma importante complicação, conforme demonstram as taxas de incidĂȘncia relatadas nos estudos incluĂdos nesta revisĂŁo. Os fatores de risco observados apontam que baixo peso ao nascer, prematuridade e maior tempo de permanĂȘncia do cateter estĂŁo relacionados Ă maior incidĂȘncia de infecção da corrente sanguĂnea. Observou-se que taxas de infecção associada a cateter em valores baixos, prĂłximos a zero, jĂĄ sĂŁo uma realidade em instituiçÔes de saĂșde de paĂses desenvolvidos, uma vez que utilizam programas de vigilĂąncia e controle de infecção. ConclusĂŁo: A infecção da corrente sanguĂnea associada a cateter ainda apresenta altas taxas de densidade de incidĂȘncia em paĂses em desenvolvimento. Destaca-se a necessidade de realização de mais estudos longitudinais e a necessidade de melhores estratĂ©gias de prevenção dos fatores de risco para a redução de infecção associada a cateter. Keywords: Catheter-related infections, Central venous catheterization, Risk factors, Palavras-chave: InfecçÔes relacionadas a cateteres, Cateterismo venoso central, Fatores de risc
Risk factors for central venous catheterârelated infections in a neonatal population â systematic review
Objective: This was a systematic review of the incidence density and risk factors for central venous catheterârelated infections in a neonatal population.
Data source: The MEDLINE, Embase, Cochrane, BDENF, SciELO, and LILACS databases were used without date or language restriction. Studies that analyzed risk factors for bloodstream infections in newborns were identified.
Data synthesis: A total of 134 articles were found that met the eligibility criteria. Of these articles, 14 were selected that addressed risk factors for central venous catheterârelated infection in neonates. Catheterârelated bloodstream infections remain an important complication, as shown by the incidence rates reported in the studies included in this review. The observed risk factors indicate that low birth weight, prematurity, and longer catheter permanence are related to a higher incidence of bloodstream infections. It has been observed that low rates of catheterârelated infections, i.e., close to zero, are already a reality in health institutions in developed countries, since they use infection surveillance and control programs.
Conclusion: Catheterârelated bloodstream infections still show high incidence density rates in developing countries. The authors emphasize the need for further longitudinal studies and the need for better strategies to prevent risk factors, aiming at the reduction of catheterârelated infections
Risk factors for central venous catheter-related infections in a neonatal population - systematic review,
Abstract Objective: This was a systematic review of the incidence density and risk factors for central venous catheter-related infections in a neonatal population. Data source: The MEDLINE, Embase, Cochrane, BDENF, SciELO, and LILACS databases were used without date or language restriction. Studies that analyzed risk factors for bloodstream infections in newborns were identified. Data synthesis: A total of 134 articles were found that met the eligibility criteria. Of these articles, 14 were selected that addressed risk factors for central venous catheter-related infection in neonates. Catheter-related bloodstream infections remain an important complication, as shown by the incidence rates reported in the studies included in this review. The observed risk factors indicate that low birth weight, prematurity, and longer catheter permanence are related to a higher incidence of bloodstream infections. It has been observed that low rates of catheter-related infections, i.e., close to zero, are already a reality in health institutions in developed countries, since they use infection surveillance and control programs. Conclusion: Catheter-related bloodstream infections still show high incidence density rates in developing countries. The authors emphasize the need for further longitudinal studies and the need for better strategies to prevent risk factors, aiming at the reduction of catheter-related infections