Surveillance of healthcare-associated bloodstream infections in neonatal intensive care unit of a tertiary care hospital

Authors

  • Pue Rakshit Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
  • Nitika Nagpal Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
  • Tuhina Banerjee Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
  • Ashok Kumar Department of Paediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India

DOI:

https://doi.org/10.3396/ijic.v22.23850

Keywords:

healthcare-associated infection, bloodstream, NICU, infection rate

Abstract

Background and objective: Healthcare-associated infections (HAIs) are a serious threat to patient safety. They cause substantial morbidity and mortality across various healthcare settings, including neonatal intensive care units (NICUs). This study was undertaken to determine the incidence of HA bloodstream infection (HA-BSI) in the NICU of a tertiary care hospital.

Methodology: Data were collected in a systematic manner based on the Centers for Disease Control and Prevention (CDC) guidelines for the surveillance of HAI for a period of 1 year (Jan–Dec, 2022). The HAI rate was calculated using the following formula: No. of cases/No. of patient days × 1,000.

Result: Among the 1,085 admitted neonates, the incidence of HA-BSI was 15.80/1,000 patient days. HAI was seen in neonates having mean birth weight 1,722.5 ± 113.906 g, mean gestational age 29.6 ± 1.38, and mean duration of hospital stay 13.8 ± 4.081 days. Among the 80 cases of HA-BSI, recognized pathogens were 22 (27.5%) Klebsiella pneumoniae, 16 (20%) non-albicans Candida, 13 (16.25%) methicillin-sensitive Staphylococcus aureus, 10 (12.5%) Candida albicans, 10 (12.5%) Acinetobacter baumannii, 4 coagulase-negative staphylococci, 3 (3.75%) methicillin-resistant Staphylococcus aureus, 1 (1.25%) Escherichia coli, and 1 (1.25%) Enterococcus. The mortality rate was 56.78%.

Conclusion: The predominance of K. pneumoniae and A. baumannii as causative pathogens suggests the need of stringent infection control measures and targeted antimicrobial strategies to reduce the burden of HAI and improve patient outcomes.

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References

1.

Mathur P, Malpiedi P, Walia K, Srikantiah P, Gupta S, Lohiya A, et al. Indian Healthcare Associated Infection Surveillance Network collaborators. Health-care-associated bloodstream and urinary tract infections in a network of hospitals in India: a multicentre, hospital-based, prospective surveillance study. Lancet Glob Health 2022; 10(9): 1317–25. doi: 10.1016/S2214-109X(22)00274-1

2.

IPC. Infection control guidelines and recommendations for healthcare settings. 2025. Available from: https://www.cdc.gov/infection-control/hcp/guidance/index.html [cited 5 April 2025].

3.

Mauger B, Marbella A, Pines E, Chopra R, Black ER, Aronson N. Implementing quality improvement strategies to reduce healthcare-associated infections: a systematic review. Am J Infect Control 2014; 42(10): 274–83. doi: 10.1016/j.ajic.2014.05.031

4.

Banerjee T, Bhattacharjee A, Upadhyay S, Mishra S, Tiwari K, Anupurba S, et al. Long-term outbreak of Klebsiella pneumoniae & third generation cephalosporin use in a neonatal intensive care unit in north India. Indian J Med Res 2016; 144(4): 622–9. doi: 10.4103/0971-5916.200900

5.

Sharma S, Das A, Garg R, Pramanik S, Marndi P, Singh R, et al. A reservoir of carbapenem-resistant Acinetobacter baumannii in the hospital environment and colonization pressure: a surveillance-based study in Indian intensive care unit. Microb Drug Resist 2022; 28(12): 1079–86. doi: 10.1089/mdr.2022.0088

6.

Banerjee T, Wangkheimayum J, Sharma S, Kumar A, Bhattacharjee A. Extensively Drug-resistant hypervirulent Klebsiella pneumoniae from a series of neonatal sepsis in a tertiary care hospital, India. Front Med (Lausanne). 2021; 8(8): 645955. doi: 10.3389/fmed.2021.645955

7.

CDC. Identifying healthcare-associated infections (HAI) for NHSN surveillance. Atlanta: Centers for Disease Control and Prevention; 2022. Available from: https://www.cdc.gov/nhsn/pdfs/pscmanual/2psc_identifyinghais_nhsncurrent.pdf [cited 3 April 2025].

8.

Johnson J, Malwade S, Agarkhedkar S, Randive B, Rajput UC, Valvi C, et al. Risk factors for health care-associated bloodstream infections in NICUs. JAMA Netw Open 2025; 8(3): 251821. doi: 10.1001/jamanetworkopen.2025.1821

9.

Kumar S, Shankar B, Arya S, Deb M, Chellani H. Healthcare associated infections in neonatal intensive care unit and its correlation with environmental surveillance. J Infect Public Health 2018; 11: 275–9. doi: 10.1016/j.jiph.2017.08.005

10.

Sadowska-Krawczenko I, Jankowska A, Kurylak A. Healthcare-associated infections in a neonatal intensive care unit. Arch Med Sci 2012; 8: 854–8. doi: 10.5114/aoms.2012.31412

11.

Yadav SK, Yadav SP, Bhatta NK, Kanodia P, Singh RR, Khanal B. Risk factors for hospital acquired bloodstream infections in neonatal intensive care unit of B.P. Koirala Institute of Health Sciences, Nepal. Sri Lanka J Child Health 2017; 46: 16–22.

12.

Rakshit P, Nagpal N, Sharma S, Mishra K, Kumar A, Banerjee T. Effects of implementation of healthcare associated infection surveillance and interventional measures in the neonatal intensive care unit: small steps matter. Indian J Med Microbiol 2023; 44: 100369. doi: 10.1016/j.ijmmb.2023.100369

13.

Orsi GB, d’Ettorre G, Panero A, Chiarini F, Vullo V, Venditti M. Hospital-acquired infection surveillance in a neonatal intensive care unit. Am J Infect Control 2009; 37(3): 201–3. doi: 10.1016/j.ajic.2008.05.009

14.

Jeong IS, Jeong JS, Choi EO. Nosocomial infection in a newborn intensive care unit (NICU), South Korea. BMC Infect Dis 2006; 6: 103. doi: 10.1186/1471-2334-6-103

15.

Bolat F, Uslu S, Bolat G, Comert S, Can E, Bulbul A, et al. Healthcare-associated infections in a Neonatal Intensive Care Unit in Turkey. Indian Pediatr 2012; 49(12): 951–7. doi: 10.1007/s13312-012-0249-4

16.

Chang D, Sharma L, Dela Cruz CS, Zhang D. Clinical epidemiology, risk factors, and control strategies of Klebsiella pneumoniae infection. Front Microbiol 2021; 22(12): 750662. doi: 10.3389/fmicb.2021.750662

17.

Mishra K, Saini M, Pragya P, Sharma S, Rakshit P, Banerjee T, et al. High burden of Carbapenem-resistant Klebsiella pneumoniae (CRKP) colonization in neonates in a tertiary care hospital in India. J Pure Appl Microbiol 2025; 19(1): 227–34. doi: 10.22207/JPAM.19.1.13

18.

Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev 2008; 21(3): 538–82. doi: 10.1128/CMR.00058-07

19.

Anstey NM, Currie BJ, Hassell M, Palmer D, Dwyer B, Seifert H. Community-acquired bacteremic Acinetobacter pneumonia in tropical Australia is caused by diverse strains of Acinetobacter baumannii, with carriage in the throat in at-risk groups. J Clin Microbiol 2002; 40(2): 685–6. doi: 10.1128/JCM.40.2.685-686.

20.

Camacho-Gonzalez A, Spearman PW, Stoll BJ. Neonatal infectious diseases: evaluation of neonatal sepsis. Pediatr Clin North Am 2013; 60(2): 367–89. doi: 10.1016/j.pcl.2012.12.003.

Published

2026-04-20

How to Cite

Rakshit, P., Nagpal, N., Banerjee, T., & Kumar, A. (2026). Surveillance of healthcare-associated bloodstream infections in neonatal intensive care unit of a tertiary care hospital. International Journal of Infection Control, 22. https://doi.org/10.3396/ijic.v22.23850

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