Antimicrob Resist Infect Control. 2026 Apr 4. doi: 10.1186/s13756-026-01736-5. Online ahead of print.
ABSTRACT
BACKGROUND: Bloodstream infections (BSI), especially central line associated BSI (CLABSI) are common severe healthcare associated infections (HAI) in very low birth weight (VLBW) neonates (< 1500 g at birth) admitted to neonatal intensive care units (NICUs). However, surveillance systems are known to contribute to reducing HAI. Our objectives were firstly, to describe BSI and CLABSI incidence in the 2015-2018 period for VLBW from 40 level III NICUs reporting data back to NeoKissEs, the Spanish neonatal surveillance system, secondly, to describe NICU organizational features and level of use of a set of recommended infection prevention (IP) practices and finally, to assess their relationships with BSI/CLABSI incidence.
METHODS: This was a retrospective analysis of a prospective cohort of VLBW infants. Using an online survey of NICU-level IP data, analysis of surveillance of individual data and NICU-specific IP information using random intercept logistic and Poisson models was carried out. Unadjusted and risk-adjusted incidence of neonates with ≥ 1 BSI episodes and BSI/CLABSI rates were estimated.
RESULTS: Data from 5260 VLBW infants were reported. Incidence of neonates with ≥ 1 BSI episodes (1420 newborns, 27.0%) decreased significantly during the study period (18.7% reduction (p = 0.002)), BSI rates dropped by 23.5% (p < 0.001) and CLABSI rates by 18.4% (p = 0.062). Lower incidence was associated only with the existence of hand hygiene (HH) audit and feedback activities (OR 0.62 [95% confidence interval 0.41-0.96]).
CONCLUSIONS: The NeoKissEs surveillance data show a high level of BSI, a downwards time trend and wide variation among NICUs in both BSI/CLABSI incidence and the extent of use of recommended IP practices. Systematic HH performance audit and feedback activities should be prioritized. NeoKissEs provides useful data for monitoring changes in BSI incidence and related factors.
PMID:41935311 | DOI:10.1186/s13756-026-01736-5
