Faculdade de Ciências Médicas/NOVA Medical School/UNL. CHLC, Dona Estefânia Hospital Lisbon. Portugal.
- Palestra. Núcleo de História da Medicina da OM. OM, Lisboa, 8 de Março de 2018
- Comunicação oral. 46th Congress of International Society for the History of Medicina (ISHM). Lisboa, 3-7 Setembro 2018
- Publicação sob forma de resumo. Livro de resumos do 46th Congress of ISHM.
Introduction: In 2008 Portuguese Directorate General of Health implemented an online registration aiming the surveillance of hospital-acquired infections of patients admitted to level III NICU’s .
Aim: To deliver information on 10-year registry of HAI’s.
Methods: Clinicians in the 19 level III major NICU’s prospectively collected data. Neo-Kiss surveillance system definitions were used. HAI was defined as clinical signs of infection starting more than 72 hours after birth or admission, with laboratory evidence supporting infection. Clinical sepsis with positive or negative blood culture, necrotising enterocolitis (NEC) and pneumonia were studied.
Results: There were 48495 admissions, 17.3% from very low birth weight (VLBW) infants, accounting for 697468 patient-days, 45% of them from VLBW infants. Median gestational age (GA) and birth weight (BW) were 36 weeks and 2480g for all patients and 29 weeks and 1105g for patients with HAI. The percentage of patients with hospital-acquired infection was 10.4. The incidence of sepsis was 5.8/1000 patient-days (VLBW: 8.3); central vascular catheter (CVC)-associated sepsis 13.6/1000 CVC-days (VLBW 15.8), NEC 0.7/1000 patient-days (VLBW 1.4) and pneumonia 0.8/1000 patient-days (VLBW 1.1). Incidence of clinical sepsis with positive or negative blood culture remained almost unchanged over the 10 years (from 5.2 to 6.5/1000 patient days). Sepsis with negative blood culture accounted for 42% of all sepsis. Coagulase-negative Staphylococcus was isolated in 65% of culture proven BSI, Staphylococcus aureus in 10.4%, gram-negative bacteria in 16% and fungus in 3%. Lethality rate was 4,6% (VLBW 6%); culture-negative infection accounted for 49% of deaths, followed by gram-negative bacteria (29%), gram-positive bacteria (18%) and fungus (2.6%).
Conclusion: HAI’s are still a problem in Portuguese NICU. There was no improvement in the incidence of sepsis from 2008 onwards. Implementation of better preventive measures is required.
Keywords: Hospital-acquired infection, Neonatal Intensive Care Units, National Registration.