Sepsis incidence and its risk factors in very low birth weight infants, a retrospective, observational investigation.

Abstract

Title: Sepsis incidence and its risk factors in Very Low Birth Weight Infants. Background: Very low birth weight (VLBW) and Extreme Low birth weight (ELBW) infants are at high risk for nosocomial sepsis (NS), which is one of the leading causes of morbidity and mortality in the neonatal intensive care unit (NICU). Total parenteral nutrition (TPN), central venous catheter (CVC), and non compliance to hand hygiene are major risk factors of NS. Since 2008, raised awareness at the healthcare workers of the NICU of the hospital under study was noticeable by multiple conducted investigations into NS and its risk factors. This resulted in changed care policy regarding NS incidence. Results of the changed policy were not studied. Aim and research question: To evaluate the changed care policy with regards to decreasing the rate of NS and Catheter related sepsis (CRS). Question was ‘did changing practice since 2008, result in a decrease of the incidence of NS and CRS among VLBW infants hospitalized in the NICU, in the period of 2008-2011?’ Method: Retrospective observational file research. Study population was VLBW infants, hospitalized in the NICU. All eligible subjects were studied. Main study parameters were NS and CRS incidence, and use of TPN and CVC. Results: The population did not change during the period. However a decrease of NS and CRS was showed, in combination with a decrease of duration of CVC and TPN. Conclusion: These decreases might be a result of the changing care policy. It emphasizes that serious evaluation of care policy can result in better practice. Recommendations: Multi-center study into NS and CRS incidences and with going care policy, would contribute to development of the best clinical practice in connection with NS and CRS in VLBW infants.