Comparison of Nosocomial Infections in NICUs of Terengganu and USM Kelantan
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Comparison of the Pattern of Nosocomial Infection Between the Neonatal Intensive Care Units of Hospitals Kuala Terengganu and Universiti Sains Malaysia, Kelantan
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:
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WH Wan Hanifah, JKF Lee, BS Quah
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Comparison of the Pattern of Nosocomial Infection Between the Neonatal Intensive Care Units of Hospitals Kuala Terengganu and Universiti Sains Malaysia, Kelantan
Year: 2000
Copyright (license): CC BY 4.0
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Summary of article contents:
Introduction
Nosocomial infections in the Neonatal Intensive Care Unit (NICU) are a major concern, as they can lead to significant morbidity and mortality among vulnerable neonates. This study aims to assess the incidence and clinical characteristics of nosocomial infections in the NICUs of Kuala Terengganu Hospital (HKT) and Universiti Sains Malaysia Hospital (HUSM) over the year 1998. It involved neonates exhibiting clinical signs of sepsis and positive blood cultures at least 48 hours after their admission to the NICU. Understanding the infection patterns will be critical for enhancing infection control measures and developing effective antibiotic policies.
Resistance Patterns of Common Organisms
The most frequently isolated pathogens in the study were Klebsiella pneumoniae in HKT and Klebsiella aerogenes in HUSM, both of which exhibited notable antibiotic resistance. Specifically, 50% of Klebsiella pneumoniae isolates were resistant to commonly used antibiotics such as cephalosporins and aminoglycosides, while a similar percentage of Klebsiella aerogenes isolates from HUSM were resistant to piperacillin and aminoglycosides. These resistance patterns highlight a concerning issue in the treatment of nosocomial infections and indicate a need for ongoing surveillance and adaptation of antibiotic policies within the NICUs. The study illustrates that both gram-positive and gram-negative organisms are prevalent causes of nosocomial sepsis, contributing to the complexity of managing infections in these sensitive populations.
Conclusion
In conclusion, nosocomial infections are a prevalent challenge in both HKT and HUSM, with similar overall incidence and mortality rates. However, HUSM neonates displayed a higher frequency of predisposing factors for infection and a greater duration of hospital stays than those in HKT. Although the types of organisms isolated and their resistance patterns differed slightly between the two hospitals, the findings underscore the necessity for robust infection surveillance and improved infection control strategies. Establishing comprehensive protocols may mitigate the impact of nosocomial infections, ultimately leading to better outcomes for neonates in NICUs.
FAQ section (important questions/answers):
What is a nosocomial infection in neonates?
Nosocomial infections are infections that manifest clinically 48 hours after a neonate's admission to the NICU, often identified through positive blood cultures.
How common are nosocomial infections in the studied hospitals?
In HKT, the incidence was 5.4%, while in HUSM it was 3.6%, indicating nosocomial infections are a prevalent issue in both hospitals.
What are the common organisms causing nosocomial infections?
The most common organisms isolated were Klebsiella pneumoniae in HKT and Klebsiella aerogenes in HUSM, with additional organisms including Staphylococcus aureus and coagulase-negative staphylococci.
What factors increase the risk of nosocomial infections in neonates?
Significant risk factors include the use of invasive procedures, central lines, and parenteral nutrition, with a higher incidence noted in HUSM compared to HKT.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Comparison of Nosocomial Infections in NICUs of Terengganu and USM Kelantan”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Study (Studying):
The term 'Study' refers to the systematic investigation conducted to understand the incidence and clinical characteristics of nosocomial infections in neonates within two NICUs. By comparing data from both hospitals, researchers aimed to provide insights that could enhance infection control measures and inform antibiotic policies, ultimately improving neonatal care.
2) Birth:
In the context of this research, 'Birth' signifies the critical period when neonates are particularly vulnerable to infections due to an immature immune system. The study highlights that low birth weight and prematurity are significant risk factors associated with nosocomial infections in neonatal intensive care units.
3) Antibiotic (Antibacterial):
'Antibiotic' refers to the medications employed to treat infections identified in the study. Understanding antibiotic resistance patterns among common pathogens was essential for developing effective treatment protocols. The study emphasizes the importance of monitoring antibiotic effectiveness in managing nosocomial infections to improve neonatal outcomes.
4) Line:
'Line' indicates the central venous lines or umbilical catheters used for administering medication and nutrition to neonates. These invasive procedures pose risks for infection, as seen in the higher rates of nosocomial infections related to central lines in HUSM compared to HKT, thus underscoring the need for careful line management.
5) Table:
'Table' refers to the organized compilation of data presented within the study. It conveys clinical characteristics, demographics, and risk factors of neonates with nosocomial infections. Tables are vital for summarizing complex information, enabling easier comparison across different hospitals and facilitating interpretation of the study results.
6) Blood:
'Blood' is significant as the primary medium through which infections manifest in the neonates studied. Blood cultures were used to diagnose nosocomial infections. The study specifically focused on identifying bacterial isolates from positive blood cultures, determining their prevalence and resistance patterns in the NICU populations examined.
7) Life:
'Life' highlights the critical nature of neonatal care, especially in intensive settings where vulnerable newborns are at risk of infections. The study addresses infections that develop later in life, impacting overall survival rates and long-term health outcomes, emphasizing the need for protective measures during this delicate stage.
8) Developing:
'Developing' refers to the ongoing process of understanding and improving neonatal care practices. The study contributes to the developing body of knowledge concerning nosocomial infections, their causes, and prevention strategies, thereby enhancing practices in NICUs and aiding health professionals in mitigating infection risks for infants.
9) Disease:
'Disease' encompasses the health complications arising in neonates due to nosocomial infections. By studying the different pathogens and their resistance to antibiotics, the research aims to understand the disease patterns better, helping healthcare providers recognize potential outbreaks and develop effective treatment strategies tailored for this population.
10) Storm:
'Storm' likely refers to a reference within the study regarding a phenomenon or specific finding related to transient bacteremia following medical procedures, such as endotracheal suctioning. Understanding these risks, which can lead to infections, is critical in refining clinical practices and safeguarding neonatal health.
11) Sign:
'Sign' denotes the clinical manifestations that indicate the presence of an infection in neonates. Recognizing these signs early can significantly influence management strategies. The study aims to correlate clinical signs with laboratory findings, improving the ability of healthcare providers to respond promptly to potential sepsis cases.
12) Knowledge:
'Knowledge' emphasizes the importance of information gained from the study. This research enhances the current understanding of nosocomial infections in NICUs, providing valuable insights that can inform better clinical guidelines, improve infection control measures, and ultimately increase survival and health outcomes for neonates.
13) Substance:
'Substance' here may refer to the biological materials, such as blood or intravenous solutions, that can be sources of infections due to contamination. Understanding the implication of various substances used in neonatal care can help in preventing nosocomial infections and optimizing safe practices within NICUs.
14) Species:
'Species' refers to the different types of organisms causing infections in neonates, particularly bacteria identified in the study, such as Klebsiella pneumoniae and Klebsiella aerogenes. The classification of these species helps in understanding their pathogenic potential and guiding appropriate antibiotic treatment regimens.
15) Surface:
'Surface' in the study could refer to the contamination of medical devices, such as catheters, which can act as reservoirs for bacteria, leading to infections. Understanding how surface contamination contributes to infection risks emphasizes the need for stringent infection control measures in NICUs.
16) Aureus:
'Aureus' likely refers to Staphylococcus aureus, a significant pathogen identified in the study associated with neonatal infections. Its presence highlights the role of gram-positive bacteria in nosocomial infections and the critical need for effective antibiotic policies to manage such resistant organisms within NICUs.
17) Kannan (Kannaṉ, Kaṇṇaṉ, Kaṉṉaṉ, Kaṉṉāṉ):
'Kannan' refers to one of the authors, associated with previous studies or findings regarding bacterial sepsis in neonates. Acknowledging contributions from various researchers in the field enriches the study's context, connoting a continuum of research efforts aimed at improving neonatal healthcare.
18) Reason:
'Reason' indicates the underlying causes identified for increased rates of nosocomial infections in NICUs, such as invasive procedures and varying hospital policies. Understanding these reasons can guide improvements in clinical practice aimed at minimizing the risk factors associated with such infections.
19) Bharu (Bhāru):
'Bharu' could refer to Kota Bharu, a location tied to the researchers' study context in Malaysia. The geographical aspect emphasizes the relevance of local health practices and infection statistics, enriching the understanding of nosocomial infections in neonates within specific cultural and healthcare settings.
20) Queen:
'Queen' likely refers to the Queen Elizabeth Hospital mentioned in comparison or context regarding similar studies on nosocomial infections. This highlights collaboration or benchmark data from various hospitals to examine infection rates and management practices systematically.
21) Fever:
'Fever' is a clinical sign that may indicate an underlying infection in neonates, including those with nosocomial infections. Monitoring febrile episodes in this population is critical for identifying potential infections early, which can ultimately affect treatment outcomes and reduce mortality rates.
22) Death:
'Death' signifies the serious consequence of untreated or improperly managed nosocomial infections in neonates. This study assessed the mortality rates associated with these infections, aiming to identify patterns that can reduce mortality and improve neonatal care practices in intensive settings.
23) Visit:
'Visit' refers to the healthcare encounters necessary for monitoring and managing the neonates' health. Regular visits can detect early signs of infection or complications, which is crucial for the timely implementation of infection control measures in the NICU environment.
24) Lemon:
'Lemon' likely metaphorically relates to the nuances of healthcare experiences, possibly pointing to the broad implications of the study's findings on neonatal care practices. The term emphasizes the importance of 'sour' experiences being transformed into 'sweet' outcomes through improved clinical approaches.
25) Kota (Koṭa):
'Kota' might refer to Kota Bharu or another city contextually related to the research. Understanding local health dynamics and resources is essential for framing the study's findings within the broader Malaysian healthcare landscape, influencing practice improvements to enhance neonatal care.
26) Male (Mālē):
'Male' conveys the gender distribution among neonates with nosocomial infections. The study reported similar proportions of male to female neonates, highlighting demographic aspects that could influence future research into infection susceptibility and management practices tailored to gender-specific needs.
27) Bell:
'Bell' might refer to a researcher or medical professional involved in studies of neonatal infections. Acknowledging the contributions of different researchers adds credibility to the findings, contextualizing the presented data within a wider body of evidence from previous research in the field.
28) Salt (Salty):
'Salt' likely pertains to the University of Utah Medical Centre, Salt Lake City, cited in the study to illustrate the varying incidences of nosocomial infections across different medical environments. This comparison highlights the need for region-specific strategies and tailored approaches to infection control and prevention.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Comparison of Nosocomial Infections in NICUs of Terengganu and USM Kelantan’. Further sources in the context of Science might help you critically compare this page with similair documents:
Antibiotic therapy, Predisposing Factor, Low birth weight, Morbidity and Mortality, Birth weight, Mortality Rate, Infection Control, Staphylococcus aureus, Systemic infection, Prematurity, Gestational age, Klebsiella pneumoniae, Gram-negative bacilli, Hospital stay, Prophylactic Antibiotic, Risk factor, Bacterial and fungal infections, Invasive Procedure, Nosocomial infection, Bacteraemia, Invasive devices, Blood culture, Coagulase negative Staphylococci, Gram positive organism, Gram negative organism, Bacterial colonization, Hospital infections, Maternal infection, Neonatal intensive care unit, BLOODSTREAM INFECTIONS, Respiratory Distress Syndrome, Risk of infection, Understaffing, Transient bacteremia, Neonatal sepsis, Parenteral nutrition, Mean duration, Neonatal Intensive Care, Endotracheal intubation, Late onset sepsis, Positive blood culture, Very Low Birth Weight, Maternal fever, Positive pressure ventilation, Clinical characteristic, Endotracheal suctioning, Klebsiella aerogenes, Antibiotic policies, Infection control measure, Bacterial and fungal, Acquired infection, Clinical signs of sepsis.
Concepts being referred in other categories, contexts and sources.