Risk-adjusted surveillance of hospital-acquired infections in neonatal intensive care units: a systematic review.

The Journal of Hospital Infection
P PhillipsR Gilbert

Abstract

Comparisons of bacteraemia incidence between neonatal intensive care units (NICUs) can identify centres with effective infection control, whose practices can be shared with other units. For fair comparisons, infection incidence must be risk-adjusted to control for differences between centres in the vulnerability of babies and the intensity of invasive procedures which can introduce infection. We reviewed risk adjustment methods for between-NICU comparisons of bacteraemia incidence, both in the published literature and in regional and national NICU infection monitoring systems. PubMed and Embase were searched for studies reporting risk-adjusted bacteraemia incidence in more than one NICU. An internet search found NICU infection monitoring systems in Western industrialised countries. In all nine studies that met the inclusion criteria, risk adjustment reduced but did not eliminate variation in bacteraemia incidence between NICUs. In both the studies and the regional monitoring systems, adjustment for baby susceptibility generally involved stratification by factors measured at birth. Adjustment for Length of stay and invasive procedures involved reporting incidence by days with a device, such as central venous catheter days. Metho...Continue Reading

References

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Aug 17, 2002·The Pediatric Infectious Disease Journal·Li-Yin ChienUNKNOWN Canadian Neonatal Network
Jul 18, 2003·The Pediatric Infectious Disease Journal·Maria Patrizia CarrieriUNKNOWN Italian Study Group on Hospital Acquired Infections in Neonatal Intensive Care Units
Mar 11, 2004·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·F D DaschnerA Widmer
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Citations

May 7, 2013·Archives of Disease in Childhood. Fetal and Neonatal Edition·Laura FolgoriMike Sharland
Jul 5, 2012·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Pamela LeightonRuth Gilbert
Jan 24, 2012·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·P LeightonR Gilbert
May 29, 2009·Current Opinion in Infectious Diseases·Eoghan O'Neill, Hilary Humphreys
Mar 11, 2015·Pediatrics·Evelien Hilde VerstraeteStijn Blot

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