Epidemiology, risk factors, and applicability of CDC definitions for healthcare-associated bloodstream infections at a level IV neonatal ICU

ObjectivesWe studied the epidemiology of primary bloodstream infections (BSIs), secondary BSIs, and central line-associated BSIs (CLABSIs) and applicability of CDC definitions for primary sources of infection causing secondary BSIs in patients in the neonatal ICU.Study designWe classified healthcare-associated BSIs (HABSIs) as primary BSIs, secondary BSIs, and CLABSIs using CDC surveillance definitions and determined their overall incidence and incidence among different gestational age strata. We assessed the applicability of CDC definitions for infection sources causing secondary BSIs.ResultsFrom 2010 to 2019, 141 (32.7%), 202 (46.9%), and 88 (20.4%) HABSIs were classified as primary BSIs, secondary BSIs, and CLABSIs, respectively; all declined during the study period (all p < 0.001). Gestational age <28 weeks was associated with increased incidence of all HABSI types. CDC criteria for site-specific primary sources were met in 137/202 (68%) secondary BSIs.ConclusionsPrimary and secondary BSIs were more common than CLABSIs and should be prioritized for prevention.

Automated summary

This study investigated the epidemiology of primary bloodstream infections (BSIs), secondary BSIs, and central line-associated BSIs (CLABSIs) in neonatal intensive care unit patients, as well as the applicability of CDC definitions for infection sources causing secondary BSIs. The results showed a decline in the incidence of primary BSIs, secondary BSIs, and CLABSIs during the study period. Gestational age <28 weeks was associated with increased incidence of all types of healthcare-associated BSIs. CDC criteria for site-specific primary sources were met in a majority of secondary BSIs.