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A 6-year prospective surveillance of healthcare-associated infections in a neonatal intensive care unit from southern part of Turkey


Dr Hacer Yapicioglu Yildizdas, Department of Pediatrics, Division of Neonatology, Faculty of Medicine, Cukurova University 01330, Adana, Turkey. Fax: +90 322 3386610; email:


Aim:  To report the incidence of healthcare-associated infections (HAIs), site of infection and bacterial epidemiology in the Neonatal Intensive Care Unit in a university hospital in Adana, Turkey, between 2001 and 2006.

Methods:  During these years, HAIs were collected by an active surveillance system.

Results:  Five hundred one of 2832 infants hospitalised more than 72 h had 1124 HAI. The HAI incidence and incidence density ranged between 14.1 and 29.7 infections/100 patients, and 10.9–17.3 infections/1000 patient days within the study period; 61.5% of HAIs were ventilator-associated infections; 26.2% were bloodstream infections; 3.5% were urinary tract infections; 3.5% were necrotising enterocolitis (Stages II and III) and 1.4% was meningitis. The most frequent pathogens were gram-negative pathogens (75.6% of all infections) followed by gram-positive micro-organisms (21.4%) and Candida species (3.0%). Birthweight, gestational age and Apgar scores were lower and overall mortality rate (32.9% vs. 19.7%) and number of inpatient days were higher in patients with HAIs (for all P < 0.001) when compared with those who did not have HAIs. Furthermore, HAI rate was inversely related to birthweight (P < 0.001).

Conclusion:  In this study, the overall infection rate is high compared with developed countries and predominant micro-organisms are gram-negative enteric rods. These results strongly suggest the need for improving measures for prevention and control of HAIs in this hospital.

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