Abstract
Background
Outbreaks on neonatal intensive care units (NICUs) achieve huge media interest, but the real number of neonatal outbreaks within a country is unknown.
Method
This calculation is based on the data of the component for nosocomial infections in very low birth weight (VLBW) infants of the German national nosocomial infection surveillance system (NEO-KISS) from 2006 to 2011. Almost all German NICUs caring for VLBW infants participated in this surveillance system. A cluster was defined and an outbreak was assumed when at least two cases of severe neonatal infection (bloodstream infection, pneumonia) occurred within a defined time interval in one center with the same pathogen species in different patients. Four different intervals were used for calculation: 14, 30, 60, and 90 days. Infections with coagulase-negative staphylococci (CoNS) were excluded.
Results
A total of 228 NICUs provided data in the six-year study period. A total of 37,038 VLBW infants and 1,361,950 patient days were used for the calculation. 7,405 severe neonatal infections occurred, and a microbiological detection of the pathogen was successful in 2,084 cases. Altogether, between 121 and 280 outbreaks were calculated according to the different time intervals used. Most outbreaks were due to Staphylococcus aureus, followed by Enterococcus spp. and Enterobacter spp.
Conclusion
It can be assumed that at least between 26 and 61 neonatal outbreaks with at least two severe infections take place in German NICUs per year. The actual number seems to be higher because only laboratory-confirmed infections in a subgroup of patients were used for the analysis.
Similar content being viewed by others
References
Bhakdi S, Krämer I, Siegel E, Jansen B, Exner M. Use of quantitative microbiological analyses to trace origin of contamination of parenteral nutrition solutions. Med Microbiol Immunol. 2012;201:231–7.
Tuffs A. Poor hospital hygiene is blamed for deaths of three babies in Bremen. BMJ. 2011;343:d7396.
Tuffs A. Neonatal ward in Bremen is closed down again after two more deaths of babies. BMJ. 2012;344:e1680.
Richter-Kuhlmann E. Serratien an der Charité: Baby starb nicht an Keimbefall. Dtsch Arztebl. 2012;109:A-2220.
Geffers C, Baerwolff S, Schwab F, Gastmeier P. Incidence of healthcare-associated infections in high-risk neonates: results from the German surveillance system for very-low-birthweight infants. J Hosp Infect. 2008;68:214–21.
Gastmeier P, Geffers C, Schwab F, Fitzner J, Obladen M, Rüden H. Development of a surveillance system for nosocomial infections: the component for neonatal intensive care units in Germany. J Hosp Infect. 2004;57:126–31.
Leistner R, Piening B, Gastmeier P, Geffers C, Schwab F. Nosocomial infections in very low birthweight infants in Germany: current data from the National Surveillance System NEO-KISS. Klin Padiatr. 2013;225:75–80.
Haller S, Abu Sin M, Benzler J, Gilsdorf A, Eckmanns T. Implementation of a nationwide centralised system for surveillance of healthcare-associated outbreaks in Germany, 2011/2012. Abstract, ECCMID 2013, Berlin, Germany, April 2013. http://registration.akm.ch/einsicht.php?XNABSTRACT_ID=166057&XNSPRACHE_ID=2&XNKONGRESS_ID=180&XNMASKEN_ID=900.
Gastmeier P, Loui A, Stamm-Balderjahn S, Hansen S, Zuschneid I, Sohr D, et al. Outbreaks in neonatal intensive care units—they are not like others. Am J Infect Control. 2007;35:172–6.
Härtel C, Faust K, Avenarius S, Bohnhorst B, Emeis M, Gebauer C, et al. Epidemic microclusters of blood-culture proven sepsis in very-low-birth weight infants: experience of the German Neonatal Network. PLoS One. 2012;7:e38304.
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Schwab, F., Geffers, C., Piening, B. et al. How many outbreaks of nosocomial infections occur in German neonatal intensive care units annually?. Infection 42, 73–78 (2014). https://doi.org/10.1007/s15010-013-0516-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s15010-013-0516-x