Epidemiologic trends in nosocomial bacteremia in a neonatal intensive care unit

Sung-Hsi Wei¹, Hsiu-Hui Chiu¹, Kuo-Chen Hung¹, Jen-Hsian Wang², Bai-Horng Su¹, Hung-Chih Lin¹, Tsung-Wen Lin¹, Hsiao-Chuan Lin^1
1Department of Pediatrics and ²Section of Infectious Disease, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan

Received: August 10, 2004 Revised: October 4, 2004 Accepted: December 4, 2004

Corresponding author: Dr. Hsiao-Chuan Lin, Department of Pediatrics, China Medical University Hospital, 2 Yuh Der Road, Taichung 404, Taiwan. E-mail:

The primary goal of this study was to analyze the epidemiologic features of nosocomial bloodstream infection (NBSI) in a neonatal intensive care unit over a 7-year period. All neonatal patients with NBSI treated from January 1997 to December 2003 were retrospectively analyzed. 232 NBSI episodes were diagnosed in 208 patients. The average NBSI patient-day rates were 4.69 and 2.59 per 1000 patient-days in 1997-1999 and 2000-2003, respectively. The average NBSI rates were 5.00 and 1.50 per 1000 patient days in neonates <1500 g and >1500 g, respectively. The proportion of Gram-positive organisms increased from 24% in 1997-2001 to 41% in 2002-2003, whereas the proportion of Gram-negative isolates decreased from 65% in 1997-2001 to 47% in 2002-2003. The implementation of measures for the prevention of nosocomial infection was associated with the reduction of NBSI rates. Low birth weight was demonstrated to be a significant risk factor for NBSI. The fact that Gram-positive organisms were isolated in increasing frequency may impact on the appropriate selection of empiric antimicrobial therapy for NBSI in the neonatal intensive care unit.

Key words: Bacteremia, cross infection, low birth weight infant, neonatal intensive care units, risk factors

J Microbiol Immunol Infect 2005;38:283-288.