Resumo

Newborns admitted to intensive care units are at high risk for developing nosocomial infections (NIs) because of the severity of their illness and exposure to invasive medical devices such as mechanical ventilators and central venous catheters (CVCs) and resistant microorganisms. Surveillance of Nosocomial Infections (NIs) is an essential part of quality patient care, however, there are few reports of National Healthcare Safety Network (NHSN) surveillance use in Neonate Intensive Care Units (NICU) and none in developing countries. The aim of this study was to report the incidence of NIs, causative organisms, and antimicrobial susceptibility patterns in a large cohort of neonates who was cared for during a 16-year period. Patients included in the research were followed five times per week from their birth to their discharge or death and followed-up through epidemiological surveillance, according to the NHSN. From January 1997 to December 2012, 4615 neonates were admitted to the NICU, which represented 62,412 patient-days. The device-associated infection rates were as follows: 17.3 primary bloodstream infection per 1,000 central line-days and 3.2 pneumonias per 1,000 ventilator-days. A total of 1,182 microorganisms were isolated from sterile body site cultures in 902 neonates. Coagulase-negative Staphylococcus (CoNS) (34.3%) and Staphylococcus aureus (15.6%) were the most common etiologic agents isolated from cultures. The incidences of oxacillin-resistant CoNS and S. aureus were 86.4% and 28.3%, respectively. The most important NI remains BSI with staphylococci as predominant pathogen, which showed much higher rates than those reported in the literature. Multiresistant microorganisms, especially oxacillin-resistant staphylococci and Gram-negative bacilli resistant to cephalosporin were frequent. The process of evaluating the causative organisms was valuable by employment of strict hygiene measures and careful care of the infected infants.