Nosocomial sepsis in NICU department in Taleghani hospital, 2001-2002

Nosocomial sepsis continues to be a significant cause of mortality in neonatal intensive care unit (NICU). Various interventional policies have been adopted to reduce its incidence. This study was designed to investigate the role of preventive strategies to bring down the incidence of nosocomial sepsis in the NICU.

The NICU was moved to a new location in 2002. This study was conducted in two phases. Data was collected from case note of neonates admitted to NICU in 2001, and compared to data from neonates admitted to the new NICU in 2002, and followed prospectively. Changes in new location included: large space, elbow operated water taps, availability of disposable endotracheal tubes, and insistence on strict hand washing with continuous surveillance. Neonates who had a negative blood culture on admission, and a positive blood culture 48hr later, plus clinical and/or paraclinical signs compatible with sepsis, were selected. The incidence of nosocomial sepsis was compared in babies admitted during 2 study periods,

In 2001, nosocomial sepsis developed in 41 out of 285 neonates (14.3%), however, in 2003 it was developed in 24 out of 298 admissions (8%) (p<0.02).

Preventive measures including an increase in bed space from 1.5M² to 2.5 M², using disposable endotracheal tubes, elbow operated water taps, and strict hand washing, result in a significant decline in nosocomial sepsis.