Abstract

The lowest-birth-weight premature is very susceptible for nosocomial infections. These infants require the most invasive therapeutic interventions and the longest exposure to environment conductive for microbial colonization. Incidence of nosocomial infection and risk factors in premature has been compared over two years, 2010 and 2015. We examined the effects of common procedures on the incidence of nosocomial sepsis. Birth weight, distribution of pathogens and the therapeutically procedures had been analysed. We tried to find strategies to minimise the risks for acquiring sepsis. Hospital documentation from neonatal intensive care unit (NICU) has been analysed retrospectively during two different years in the University Hospital Osijek. Incidence of nosocomial sepsis among hospitalised premature has been 8.9% in 2010, and 4.8% in 2015. The highest rate of affected infants weighed below 1,500 g in both periods. Statistically significance in these two periods has been found in the percentage of pre-term infants with umbilical vein catheter (UVC), and in the number of pre-term on invasive mechanical ventilation. The most common pathogen in 2010 was methicillin-resistant Staphylococcus epidermidis (MRSE), and in 2015 coagulase negative Staphylococci (CONS). The percentage of Candida parapsylosis was higher in 2015. Lowering the incidence of late-onset sepsis has been accomplished by using peripherally inserted central catheters (PICCs) and non-invasive mechanical ventilation. Invasive procedures must be avoided as much as possible.

Key words: low-birth-weight pre-term infants, nosocomial infections, risk factors, umbilical venous catheters, NICU, PICC, mechanical ventilation, high-flow nasal cannula

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