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Feeding Practices, Lines, and Hospital-Acquired Infection during the Sustenance Phase of Infection Control Quality Improvement
Objectives Nosocomial infections are a significant threat to the survival and neurodevelopment of neonates .The present study attempts to correlate enteral feeding practices as measured by nil per oral (NPO days) with bloodstream infection (BSI) rates and central line-associated bloodstream infection (CLABSI) over a period of 2 years and 3 months.
Methods This was a prospective observational study done in a tertiary level neonatal intensive care unit (NICU). Data were recorded on the presence of central lines or peripheral intravenous (IV) lines, receipt of intravenous fluids (IVF), total parenteral nutrition (TPN) or IV antibiotics, and mechanical ventilation status. BSI and CLABSI, regarded as sentinel events, were recorded and root cause analysis done.
Results A total of 3,448 infants constituting 17,846 patient days with mean gestational age and birth weight of 34.3 ± 3 weeks and 1,868 ± 434 g, respectively were studied. NPO per 1,000 days shows a significant positive correlation with BSI (ρ = 0.513; p = 0.004), CLABSI (ρ = 0.425; p = 0.021), antibiotic days (ρ = 0.7; p < 0.000), IV fluid days (ρ = 0.459; p = 0.014), and central line days (ρ = 0.634; p < 0.001). The IV fluid days showed correlation with BSI (ρ = 0.4, p ≤ 0.03) and CLABSI (ρ = 0.43, p = 0.02).
Conclusion BSI in NICU correlates with higher NPO and IV fluid days. Strengthening of enteral feeding practices reduces health care-associated infections.
Received: 28 May 2020
Accepted: 19 October 2020
07 December 2020 (online)
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- 1 Ramasethu J. Prevention and treatment of neonatal nosocomial infections. Matern Health Neonatol Perinatol 2017; 3: 5
- 2 Dong Y, Speer CP. Late-onset neonatal sepsis: recent developments. Arch Dis Child Fetal Neonatal Ed 2015; 100 (03) F257-F263
- 3 Polin RA, Denson S, Brady MT. Committee on Fetus and Newborn, Committee on Infectious Diseases. Strategies for prevention of health care-associated infections in the NICU. Pediatrics 2012; 129 (04) e1085-e1093
- 4 Testoni D, Hayashi M, Cohen-Wolkowiecz M. et al. Late-onset blood stream infections in hospitalized term infants. Pediatr Infect Dis J 2014; 33: 920-923
- 5 Okada Y, Klein N, Van Saene HK. et al. Immune response to invading bacteria is impaired in neonates receiving parenteral nutrition. Proc Nutr Soc 1997; 56: 218A
- 6 Leaf A, Dorling J, Kempley S, McCormick K, Mannix P, Brocklehurst P. ADEPT—abnormal Doppler enteral prescription trial. BMC Pediatr 2009; 9: 63
- 7 Patel AL, Johnson TJ, Engstrom JL. et al. Impact of early human milk on sepsis and health-care costs in very low birth weight infants. J Perinatol 2013; 33 (07) 514-519
- 8 Flidel-Rimon O, Friedman S, Lev E, Juster-Reicher A, Amitay M, Shinwell ES. Early enteral feeding and nosocomial sepsis in very low birthweight infants. Arch Dis Child Fetal Neonatal Ed 2004; 89 (04) F289-F292
- 9 Nangia S, Bishnoi A, Goel A, Mandal P, Tiwari S, Saili A. Early total enteral feeding in stable very low birth weight infants: a before and after study. J Trop Pediatr 2018; 64 (01) 24-30
- 10 Krishnamurthy S, Gupta P, Debnath S, Gomber S. Slow versus rapid enteral feeding advancement in preterm newborn infants 1000-1499 g: a randomized controlled trial. Acta Paediatr 2010; 99 (01) 42-46
- 11 Rosado V, Camargos PAM, Anchieta LM. et al. Risk factors for central venous catheter-related infections in a neonatal population—systematic review. J Pediatr (Rio J) 2018; 94 (01) 3-14