Risk factors for nosocomial infections in critically ill newborns: A 5-year prospective cohort study
Abstract
Background Nosocomial infections (NIs) are one of the most important causes of morbidity in neonatal intensive care units (NICUs). The aim of this study was to identify risk factors (RFs) for NIs among critically ill newborn patients in a Brazilian NICU.Methods This 5-year prospective cohort study in an 8-bed NICU included all infants born in the hospital and admitted to the NICU from 1993 to 1997. Exposure variables were maternal and newborn data prospectively collected from patient records. Univariate and multivariate analyses were used to determine independent RFs associated with NIs.Results Univariate analysis indicated gestational age, congenital abnormality, premature rupture of membranes, maternal illness, birth weight, mechanical ventilation, central venous catheter, total parenteral nutrition, peripheral venous catheter, and length of stay as possible RFs. Multivariate analysis identified 5 independent RFs for NIs: premature rupture of membranes (hazard ratio [HR] = 1.51 [95% CI, 1.15-1.99]), maternal disease (HR = 1.57 [95% CI, 1.18-2.07]), mechanical ventilation (HR = 2.43 [95% CI, 1.67-3.53]), central venous catheter (HR = 1.70 [95% CI, 1.21-2.41]), and total parenteral nutrition (HR = 4.04 [95% CI, 2.61-6.25]).Conclusion The recognition of RFs for NIs is an important tool for the identification and development of interventions to minimize such risks in the NICU.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Current guidelines recommend hospitalization and invasive therapy for neonates with "possible congenital syphilis".
“Current guidelines recommend hospitalization and invasive therapy for neonates with “possible congenital syphilis””
From Efectividad del tratamiento de la sífilis gestacional en el último trimestre sobre la incidencia de sífilis congénita: revisión sistemática y metanálisis (2025) · cites this paper as [47]
The recommendation for hospitalization and invasive therapy for neonates with "possible congenital syphilis" increases the theoretical risk of healthcare-associated infections.
“increasing the theoretical risk of healthcare-associated infections 47.”
From Efectividad del tratamiento de la sífilis gestacional en el último trimestre sobre la incidencia de sífilis congénita: revisión sistemática y metanálisis (2025) · cites this paper as [47]
Cites
CDC definitions for nosocomial infections, 1988
Garner, J. S., Jarvis, W. R., Emori, T. G., Horan, T. C., & Hughes, J. M. (1988) · American Journal of Infection Control · doi:10.1016/0196-6553(88)90053-3 · Cited by 5,665 · see citing works
CDC definitions for nosocomial infections
Yangco, B. G. (1989) · American Journal of Infection Control · doi:10.1016/s0196-6553(89)80013-6 · Cited by 3,779 · see citing works
Infectious Diseases of the Fetus and Newborn Infant
Remington, J. S., & Klein, J. O. (1984) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-198401000-00024 · Cited by 2,473 · see citing works
Haley, R. W., Culver, D. H., White, J., Morgan, W. M., Emori, T. G., Munn, V. P., & Hooton, T. M. (1985) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a113990 · Cited by 2,037 · see citing works
A practical classification of newborn infants by weight and gestational age.
Battaglia, F., & Lubchenco, L. (1967) · Jornal de Pediatria · doi:10.1016/s0022-3476(67)80066-0 · Cited by 1,301 · see citing works
Hospital Epidemiology and Infection Control
Mayhall, C. G. (2011) · Cited by 1,175 · see citing works
Gynecologists (1983) · Medical Entomology and Zoology · Cited by 910 · see citing works
Boyle, C. A., Yeargin‐Allsopp, M., Doernberg, N. S., Holmgreen, P., Murphy, C. C., & Schendel, D. (1996) · PubMed · Cited by 835 · see citing works
The International Neonatal Network (1993) · The Lancet · doi:10.1016/0140-6736(93)92296-6 · Cited by 773 · see citing works
Prevention of Perinatal Group B Streptococcal Disease: A Public Health Perspective
(1996) · PsycEXTRA Dataset · doi:10.1037/e547302006-001 · Cited by 707 · see citing works
Guideline for Prevention of Intravascular-Device-Related Infections
Pearson, M. L. (1996) · Infection Control and Hospital Epidemiology · doi:10.2307/30141155 · Cited by 536 · see citing works
Guideline for Prevention of Nosocomial Pneumonia
Tablan, O. C., Anderson, L. J., Arden, N. H., Breiman, R. F., Butler, J. C., & McNeil, M. M. (1994) · Infection Control and Hospital Epidemiology · doi:10.2307/30147436 · Cited by 509 · see citing works
Pearson, M. L. (1996) · American Journal of Infection Control · doi:10.1016/s0196-6553(96)90058-9 · Cited by 492 · see citing works
Gaynes, R. P., Edwards, J. R., Jarvis, W. R., et al. (1996) · PubMed · Cited by 398 · see citing works
Nosocomial Infections Among Neonates in High-risk Nurseries in the United States
Gaynes, R. P., Edwards, J. R., Jarvis, W. R., et al. (1996) · PEDIATRICS · doi:10.1542/peds.98.3.357 · Cited by 379 · see citing works
Birth Weight and Illness Severity: Independent Predictors of Neonatal Mortality
RICHARDSON, D., Phibbs, C. S., Gray, J. E., McCormick, M. C., Workman‐Daniels, K., & Goldmann, D. A. (1993) · PEDIATRICS · doi:10.1542/peds.91.5.969 · Cited by 259 · see citing works
Guideline for Prevention of Nosocomial Pneumonia
Tablan, O. C., Anderson, L. J., Arden, N. H., Breiman, R. F., Butler, J. C., & McNeil, M. M. (1994) · Infection Control and Hospital Epidemiology · doi:10.1086/646989 · Cited by 237 · see citing works
Maternal carriage of group B streptococci in developing countries
Stoll, B. J., & Schuchat, A. (1998) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-199806000-00013 · Cited by 212 · see citing works
The changing face of neonatal infection
Philip, A. G. S. (1994) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-199412000-00005 · Cited by 94 · see citing works
Risk factors for nosocomial sepsis in newborn intensive and intermediate care units
Moro, M. L., Toni, A. D., Stolfi, I., et al. (1996) · European Journal of Pediatrics · doi:10.1007/bf02002720 · Cited by 70 · see citing works
Prolongation of hospital stay and extra costs due to hospital-acquired infection in a neonatal unit
Leroyer, A., Bédu, A., Lombrail, P., et al. (1997) · Journal of Hospital Infection · doi:10.1016/s0195-6701(97)90166-3 · Cited by 67 · see citing works
Sepsis during total parenteral nutrition
Yeung, C., Lee, H.-C., Huang, F., et al. (1998) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-199802000-00011 · Cited by 59 · see citing works
Infections Acquired in the Nursery: Epidemiology and Control
Heath, J. A., & Zerr, D. M. (2006) · Elsevier eBooks · doi:10.1016/b0-72-160537-0/50037-2 · Cited by 59 · see citing works
Gastmeier, P., Hentschel, J., de Veer, I., et al. (1998) · Journal of Hospital Infection · doi:10.1016/s0195-6701(98)90174-8 · Cited by 57 · see citing works
Nosocomial Infections in Newborn Nurseries and Neonatal Intensive Care Units
Heeg, P. (2006) · International journal of infection control · doi:10.3396/ijic.v2i1.3928 · Cited by 35 · see citing works
Nutrition and metabolism in the high-risk neonate
Poindexter, B. B., & Denne, S. C. (2011) · Elsevier eBooks · doi:10.1016/b978-0-323-06545-0.00044-3 · Cited by 31 · see citing works
Okada, Y., Klein, N. J., & Pierro, A. (1999) · Journal of Pediatric Surgery · doi:10.1016/s0022-3468(99)90182-3 · Cited by 30 · see citing works
Total parenteral nutrition directly impairs cytokine production after bacterial challenge
Okada, Y., Papp, E., Klein, N. J., et al. (1999) · Journal of Pediatric Surgery · doi:10.1016/s0022-3468(99)90190-2 · Cited by 22 · see citing works
Developing Policies and Guidelines
Brennan, P. J., & Abrutyn, E. (1995) · Infection Control and Hospital Epidemiology · doi:10.2307/30105092 · Cited by 17 · see citing works
Developing Policies and Guidelines
Brennan, P. J., & Abrutyn, E. (1995) · Infection Control and Hospital Epidemiology · doi:10.1086/647170 · Cited by 8 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Allegranzi, B., Nejad, S. B., Combescure, C., Graafmans, W., Attar, H., Donaldson, L., & Pittet, D. (2011) · The Lancet · doi:10.1016/s0140-6736(10)61458-4 · Cited by 2,514 · see citing works
Gutiérrez-Tamayo, A. M., Mirama-Calderón, L. V., Vallejo- Ortega, M. T., & Gaitán-Duarte, H. G. (2025) · Revista Colombiana de Obstetricia y Ginecología · doi:10.18597/rcog.4268 · Cited by 1 · see citing works
- Authors
- Kawagoe, J. Y., Segre, C. A. M., Pereira, C. R., Cardoso, M. F. S., Silva, C. V., & Fukushima, J. T.
- Affiliations
- Hospital Israelita Albert Einstein (BR)
- Venue
- American Journal of Infection Control
- Publisher
- Elsevier BV
- Published
- 2001-04
- Volume
- 29
- Issue
- 2
- Pages
- 109-114
- ISSN
- 0196-6553 (ISSN-L)
- OpenAlex
- W2171433508
- Cited by
- 120
- References
- 30
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 2 · 2021: 8 · 2020: 3 · 2019: 7 · 2018: 3 · 2017: 4 · 2016: 7 · 2015: 3 · 2014: 9 · 2013: 10 · 2012: 4
- FWCI
- 6.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Infection Control (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Keywords
- nosocomial infections, critically ill neonates, neonatal intensive care, risk factors, premature rupture of membranes, maternal illness, mechanical ventilation, central venous catheters, total parenteral nutrition, congenital malformations, length of hospital stay
- MeSH terms
- Analysis of Variance, Birth Weight, Brazil, Catheters, Indwelling, Cross Infection, Female, Gestational Age, Hospitals, General, Humans, Infant, Newborn, Infant, Newborn, Diseases, Intensive Care Units, Neonatal, Length of Stay, Male, Parenteral Nutrition, Total, Pregnancy, Pregnancy Complications, Prospective Studies, Respiration, Artificial, Risk Factors, Incidence, Proportional Hazards Models, Critical Illness, Infection Control
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
