Health care-associated infections in the neonatal intensive care unit, a review of impact, risk factors, and prevention strategies

Nosocomial infection or health care-associated infection (HAI) causes significant morbidity and mortality in the neonatal intensive care unit (NICU) population. Associated risk factors include low birth weight, indwelling central catheter, parenteral nutrition, prior antibiotic exposure, and invasive procedures, all of which are common in the NICU setting. Decreasing rates and minimizing risk is a priority for hospital caregivers; however, rates vary widely from center to center. This review article discusses the reported rates of HAI and central line-associated bloodstream infection in the NICU population and reviews risk factors, physical examination findings, laboratory evaluation, causative organisms, and therapies (both antimicrobial and supportive). A review and summary of interventions, which have been proven successful in reducing HAI and central line-associated bloodstream infection in the NICU patient population, is included.