International Journal of Education, Science and Social Sciences

Original Articles

Vol. 3 No. 2 (2024)

Neonatal Factors Predisposing Neonates to Nosocomial Infections at Moi Teaching and Referral Hospital

Published
2024-08-21

Abstract

Nosocomial infections occur during healthcare service delivery as an adverse outcome of medical care. They account for approximately 40% of all childhood mortality and are more common among premature neonates and those with intra-partum complications. This study aimed to assess neonatal factors that predisposes neonates to nosocomial infections in the new-born unit of Moi Teaching and Referral Hospital (MTRH). The study adopted a cross- sectional descriptive study design among neonates younger than 28 days admitted at the new-born unit in MTRH. Neonatal clinical information was obtained from their medical records. Data was statistically analysed using SPSS version 26. Categorical variables such as sex, presence of co-morbidities and feeding techniques were summarized using frequencies with corresponding percentages. Continuous variables such as gestational age at birth, duration of hospitalization among others were summarized using mean with their corresponding standard deviations (SD). Pearson chi-Square was used to determine the likelihood neonatal factors predisposing neonates to nosocomial infections. Ethical approval (Approval No: 0003349) was obtained from MTRH’s Institutional Ethical Review Committee (IREC) prior to study commencement. This study enrolled 113 neonates of whom 58 (51.3%) were preterm (gestation age of 20-37 weeks) while the rest were full term neonates (>37 weeks). Majority of the neonates had a normal birth weight with 86 (76.1%) of them having been on mechanical ventilation. This study recorded more neonates (91) whose duration of hospitalization was ≤28 days with 63 having nosocomial infection while 90 neonates were on parenteral feeding out of which 66 contracted nosocomial infections. There was no significant (p > 0.05) association between neonatal characteristics and the occurrence nosocomial infections. Occurrence of nosocomial infections statistically determined to be not dependent on neonatal characteristics. Since nosocomial infections are a major cause of neonatal morbidity that predicts childhood mortality, it is important to identify risk factors of nosocomial infections. Understanding the risk factors will inform policy updates and implementation. There is need to enhance infection prevention and control strategies at the neonatal units to help reduce the nosocomial infection burden and diversity.

References

  1. Ahoyo, T. A., Bankolé, H. S., Adéoti, F. M., Gbohoun, A. A., Assavèdo, S., Amoussou-Guénou, M., ... & Pittet, D. (2014). Prevalence of nosocomial infections and anti-infective therapy in Benin: results of the first nationwide survey in 2012. Antimicrobial resistance and infection control, 3, 1-6.
  2. Al-Jabri, R. M., Al-Hejin, A. M., Gashgari, R., Bataweel, N. M., Abu-Zaid, M., Mahmoud, M. M., Najjar, A. A., & Ahmed, M. M. M. (2019). Screening and Prevention of Nosocomial Infections in Neonatal Intensive Care Unit (NICU). Advances in Environmental Biology, 13(1), 14–23.
  3. Bangi, V. B., & Devi, Ss. (2014). Neonatal sepsis: A risk approach. Journal of Dr. NTR University of Health Sciences, 3(4), 254.
  4. Chen, Y. C., Lin, C. F., Rehn, Y. J. F., Chen, J. C., Chen, P. Y., Chen, C. H., Wang, T. M., & Huang, F. L. (2017). Reduced nosocomial infection rate in a neonatal intensive care unit during a 4-year surveillance period. Journal of the Chinese Medical Association, 80(7), 427–431.
  5. Choobdar, F. A., Ghassemzadeh, M., Abbariki, E., & Attarian, M. (2020). Clinical Charecteristics and Report of Several Iranian Neonates Bornto Mothers with Covid-19. American Journal of Pediatrics, 6(3), 303–11.
  6. Cristina, M. L., Sartini, M., & Spagnolo, A. M. (2019). Serratia marcescens infections in neonatal intensive care units (NICUs). International Journal of environmental research and public health, 16(4), 610.
  7. Das, P., Singh, A. K., Pal, T., Dasgupta, S., Ramamurthy, T., & Basu, S. (2011). Colonization of the gut with Gram-negative bacilli, its association with neonatal sepsis and its clinical relevance in a developing country. Journal of Medical Microbiology, 60(11), 1651–1660.
  8. Dobbler, P. T., Procianoy, R. S., Mai, V., Silveira, R. C., Corso, A. L., Rojas, B. S., & Roesch, L. F. W. (2017). Low microbial diversity and abnormal microbial succession is associated with necrotizing enterocolitis in preterm infants. Frontiers in Microbiology, 8(NOV), 1–12.
  9. Elliott, C. (2020). Nosocomial Infections at Three Tertiary Hospitals in Trinidad and Tobago. Biomedical Science Journal, 1–22.
  10. Fatmi, A., Rebiahi, S. A., Chabni, N., Zerrouki, H., Azzaoui, H., Elhabiri, Y., Benmassour, S., Ibáñez-Cabellos, J. S., Smahi, M. C. E., Aribi, M., Garciá-Giménez, J. L., & Pallardó, F. V. (2020). MiRNA-23b as a biomarker of culture-positive neonatal sepsis. Molecular Medicine, 26(1).
  11. Ghaith, D. M., Zafer, M. M., Said, H. M., Elanwary, S., Elsaban, S., Al-Agamy, M. H., Bohol, M. F. F., Bendary, M. M., Al-Qahtani, A., & Al-Ahdal, M. N. (2020). Genetic diversity of carbapenem-resistant Klebsiella Pneumoniae causing neonatal sepsis in intensive care unit, Cairo, Egypt. European Journal of Clinical Microbiology and Infectious Diseases, 39(3), 583–591.
  12. Israel, G. D. (1992). Determining Sample Size 1.
  13. Jahan, I. (2016). Neonate and Infant Mortality Rate; A Review.
  14. Kanamori, H., Rutala, W. A., & Weber, D. J. (2017). The Role of Patient Care Items as a Fomite in Healthcare-Associated Outbreaks and Infection Prevention. Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America, 65(8), 1412–1419.
  15. Kayange, N., Kamugisha, E., Mwizamholya, D. L., Jeremiah, S., & Mshana, S. E. (2010). Predictors of positive blood culture and deaths among neonates with suspected neonatal sepsis in a tertiary hospital, Mwanza- Tanzania. BMC Pediatrics, 10.
  16. Kumari B, A. & Vedavati, B. I., (2018). Study of the bacteriological profile of neonatal septicemia and associated risk factors. IP International Journal of Medical Microbiology and Tropical Diseases, 4(3), 132–137.
  17. Lawn, J. E., Blencowe, H., Oza, S., You, D., Lee, A. C. C., Waiswa, P., Lalli, M., Bhutta, Z., Barros, A. J. D., & Christian, P. (2014). Every Newborn: progress, priorities, and potential beyond survival. The Lancet, 384(9938), 189–205.
  18. Mehar, V., Yadav, D., Somani, P., Bhatambare, G., Mulye, S., & Singh, K. (2013). Neonatal sepsis in a tertiary care center in central India: Microbiological profile, antimicrobial sensitivity pattern and outcome. Journal of Neonatal-Perinatal Medicine, 6(2), 165–172.
  19. Moffa, M., Guo, W., Li, T., Cronk, R., Abebe, L. S., & Bartram, J. (2017). A systematic review of nosocomial waterborne infections in neonates and mothers. International Journal of Hygiene and Environmental Health, 220(8), 1199–1206.
  20. Pal, M., Kerorsa, G. B., Marami, L. M., & Kandi, V. (2020). Epidemiology, pathogenicity, animal infections, antibiotic resistance, public health significance, and economic impact of Staphylococcus aureus: a comprehensive review. American Journal of Public Health Research, 8(1), 14–21.
  21. Ramasethu, J. (2017). Prevention and treatment of neonatal nosocomial infections. Maternal Health, Neonatology and Perinatology, 3(1), 1–11.
  22. Wang, X., Buhimschi, C. S., Temoin, S., Bhandari, V., Han, Y. W., & Buhimschi, I. A. (2013). Comparative Microbial Analysis of Paired Amniotic Fluid and Cord Blood from Pregnancies Complicated by Preterm Birth and Early-Onset Neonatal Sepsis. PLoS ONE, 8(2).
  23. Yadav, S. K., Yadav, S. P., Bhatta, N. K., Kanodia, P., Singh, R. R., & Khanal, B. (2017). Risk factors for hospital acquired bloodstream infections in neonatal intensive care unit of B.P. Koirala Institute of Health Sciences, Nepal. Sri Lanka Journalof Child Health, 46(1), 16–22.
  24. Yadav, S. K., Yadav, S. P., Kanodia, P., Bhatta, N. K., Singh, R. R., & Khanal, B. (2018). Profile and Risk Factors for Nosocomial Sepsis in a Neonatal Intensive Care Unit of BPKIHS. 35.
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