Incidence and associated factor of hospital-acquired infection among neonate admitted at NICUin University ofGondar comprehensive specialized hospital Gondar, Ethiopia 2023: Prospective cohort

Abstract

Background: Hospital-acquired infections (HAIs) in neonates, also known as nosocomial infections. Incidence rates can vary depending on factors such as the hospital's infection control measures, neonatal intensive care unit (NICU) protocols, and the prevalence of pathogens in the hospital environment. The incidence of HAIs in neonates ranges widely. In developed countries, it's generally lower due to vii stringent infection control measures, while in developing countries, it tends to be higher due to resource limitations and overcrowding. Objective: To identify the Incidence and associated factors of hospital-acquired infection neonates admitted atNICU in UOGCSH. Methodology: A Prospective cohort study was conducted on incidence and associated factor of hospital-acquired infection among neonate in from September 1st 2023 up to February, 29 2024G.C.inGondar Comprehensive Specialized hospital, Gondar, Northwest Ethiopia. All patients admitted to Neonatal ICU and stayed for > 48 hour were included. Patients selected by systematic random sampling. To identify factors associated with incidence of HAI in neonates at NICUfirst cox analysis was done to each independent variable with the dependent variable. Those variables which was have association bivariate cox regression analysis with p-value <0.2 was included in the multivariate cox regression analysis. Result:A total of 247 neonate were followed for 2145 patient days. The incidence rate of hospital acquired infection was 18.2(95 % CI: 11.3 CI: 11.3 CI: 11.3 CI: 11.3 CI: 11.3 – 20.3) 20.3) 20.3) 20.3) per 1000 neonatal days of follow- up; while the overall cumulative incidence was 15.8 % over 6 months. Neonates who stayed greater than 7 daysinfections (AHR=2.5 , 95% CI: 1.3 - 7.2) , having invasive medical devices CPAP and urinary catheter , with CPAP (AHR= 7.4 , 95% CI: 2 – 27.4) , with urinary catheter (AHR= 11.55 , 95% CI: 4 – 33.3 ) had higher risks of developing HAIs. The most common type of hospital acquired infection washospital acquired sepsis and the most common etiologic agents were Klebsiellapneumonia followed by CONS. Conclusion and recommendations: the cumulative incidence of HAIs was 15.8 per 100 admitted neonates. Presence of invasive medical device (urinary catheter and CPAP) and longer stays in the hospital greater than 7 days were significantly associated with increased risk forHAI in NICU.Further studies should be conducted to assess the healthcare workers’ infection prevention practices. Physicians and nurses who are working at NICU need to follow the appropriate safe medical procedures.